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Re: Post-sterilization HCG From: art fougner, md (evsono@pipeline.com) Tue Feb 20 11:07:37 2001 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Daniel Flaherty: "humbled ectopic responses" Previous message: art fougner, md: "Re: humbled by an ectopic" doubt this woman is pregnant. art At Tue, 20 Feb 2001, Hugo D. Ribot Jr. wrote: > >Dear Listers: > >Saw a patient for one of my CNMs the other day. > >47 yo para 2022 with postpartum tubal ligation almost 17 years ago at the birth of her last child (both births vaginal). > >Has been on HRT (Estratest/Provera) since last summer. States family doc did some bloodwork (?FSH) which indicated she needed hormones. No bleeding for months but on a visit to her FP 2/6/01 reported 'spotting' 3 weeks prior. Also c/o AM nausea, "feeling bad." Had a positive urine HCG. Serum quantitative HCG on 2/6/01 was 3. > >Repeat quant HCG on 2/19/01 was 2. > >Denies pain, further spotting. My exam and U/S were unrevealing. > >Was mortified at the possibility of any pregnancy, and stated that her husband was actually even willing to have a vasectomy. > >What would y'all do? > >We discussed (before her repeat HCG of 2) that she could have a laparoscopic bilateral total salpingectomy (assuming some tubal fistulization) versus expectant management if her HCG had come back 0. > >I don't particularly feel like any action other than repeating the HCG in a week is necessary, but would like to hear your opinions. > >-- >Hugo D. Ribot Jr., M.D. FACOG >Cartersville, GA >2 MDs/3 CNMs >Private practice 11th year (no litigation to date!) > -- art fougner, md A series of 1000 cases begins with but a single anecdote. Next message: Daniel Flaherty: "humbled ectopic responses" Previous message: art fougner, md: "Re: humbled by an ectopic"

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