Re: OB-GYN-L digest 1379 re : interesting case
From: Alenka Pretnar-Darovec (alenka.pretnar-darovec@guest.arnes.si)
Fri Feb 23 03:24:03 2001
We have similar case. At laparoscopy pregnancy was in noncomunicating part, and aspiration was done. She came for
second procedure some months later. By histeroscopy step by step, as in case similar to septum resection,
comunication was established between cervical canal and noncomunitang part of uterus.
Alenka
ob-gyn-l@obgyn.net wrote:
> OB-GYN-L Digest 1379
>
> Topics covered in this issue include:
>
> 1) Re: humbled by an ectopic
> by "Mats O. Bergstrom" <mob@mbox301.swipnet.se>
> 2) Re: UMNs Woolley perpetuates mass rape-like behavior
> by evsono@pipeline.com (art fougner, md)
> 3) Fwd: Re: Doctor convicted of manslaughter
> by "G. P. Rodriguez" <geraldpr@cybermesa.com>
> 4) Re: UMNs Woolley perpetuates mass rape-like behavior (fwd)
> by Paul Prior MD <pprior@clover.net>
> 5) Re: Doctor convicted of manslaughter
> by ainsron@msn.com
> 6) OB CALCULATOR
> by jablon@empire.net (Melinda Jablonski)
> 7) Fri: relationships with the opposite sex
> by ainsron@msn.com
> 8) RELATIVE RISK
> by richard.chudacoff@medispecialty.com (Richard Chudacoff, MD)
> 9) Re: humbled by an ectopic
> by evsono@pipeline.com (art fougner, md)
> 10) Re: humbled by an ectopic
> by DoctorJoe@aol.com
> 11) Re: LATIVE RISK
> by evsono@pipeline.com (art fougner, md)
> 12) Re: UMNs Woolley perpetuates mass rape-like behavior
> by evsono@pipeline.com (art fougner, md)
> 13) Re: Doctor convicted of manslaughter
> by Paul Prior MD <pprior@clover.net>
> 14) Re: Interesting case - with questions!
> by Rafael Haciski MD <haciski@earthlink.net>
> 15) RE: Post-sterilization hCG
> by "Griffiths Malcolm (RC9) Luton & Dunstable Hospital TR" <Malcolm.Griffiths@ldh-tr.anglox.nhs.uk>
> 16) RE: Interesting case - with questions!
> by "Griffiths Malcolm (RC9) Luton & Dunstable Hospital TR" <Malcolm.Griffiths@ldh-tr.anglox.nhs.uk>
>
> ----------------------------------------------------------------------
>
> ----------------------------------------------------------------------
> Date: Wed, 21 Feb 2001 00:13:02 +0100
> ----------------------------------------------------------------------
> From: "Mats O. Bergstrom" <mob@mbox301.swipnet.se>
> To: ob-gyn-l@obgyn.net
> Subject: Re: humbled by an ectopic
> Message-ID: <4.1.20010221000100.00911250@zebra.swip.net>
> Mime-Version: 1.0
> Content-Type: text/plain; charset="us-ascii"
>
> Art wrote:
>
> >a bit about HCG titers - once had a patient with no evidence of
> >intrauterine pregnancy at a titer of 30,000.......ubsequent ultrasound
> >revealed the presence of intrauterine triplets - easily explaining the
> >hcg titer.
>
> Yes, but that was some years ago and/or an abdominal exam, I guess?
>
> The latest table I saw showing levels for finding a sac/sacs in utero
> at vaginal exam:
>
> simplex 1000 (800 in some tables)
> duplex 1600
> triplex 3400
> quadruplex 9400
>
> Mats Bergstrom, MD
> Ob Gyn
> South Hospital
> Stockholm
>
> ------------------------------
>
> ------------------------------
> Date: Tue, 20 Feb 2001 17:16:40 -0600 (CST)
> ------------------------------
> From: evsono@pipeline.com (art fougner, md)
> To: OB-GYN-L@OBGYN.NET
> Subject: Re: UMNs Woolley perpetuates mass rape-like behavior
> Message-ID: <200102202316.RAA09368@mail.medispecialty.com>
>
> i guess he's not a big fan of evidence-based medicine.
>
> art
>
> At Tue, 20 Feb 2001, Robert J Woolley wrote:
> >
> >Guess who?! Haven't heard from ol' One-Note Todd in a long time!
> >
> >---------- Forwarded message ----------
> >Date: Tue, 20 Feb 2001 11:40:02 -0800
> >From: Todd Gastaldo <gastaldo@gte.net>
> >To: letters@daily.umn.edu, tips@daily.umn.edu
> >Subject: UMNs Woolley perpetuates mass rape-like behavior
> >
> >"It is the mission of the [University of Minnesota] Academic Health Center
> >to be the leader in ethical, innovative and efficient discovery and
> >dissemination of knowledge to enhance the health of the women of Minnesota,
> >the nation and the world."
> >http://www.med.umn.edu/obgyn/
> >
> >OPEN LETTER
> >
> >Minnesota Daily
> >2301 University Ave., SE
> >Minneapolis, MN55414
> >Phone: 612-627-4070
> >Fax: 612-627-4159
> >tips@daily.umn.edu
> >
> >To the Editor:
> >
> >Robert J. Woolley, MD indicated in his Feb. 20 editorial (Guns effective
> >defense against rape) that the University of Minnesota mixes "forcible sex
> >offenses" with "events that would not be classified as rape or attempted
> >rape."
> >http://www.daily.umn.edu/daily/2001/02/20/editorial_opinions/oo0220/
> >via http://forums.obgyn.net/ob-gyn-l/OBGYNL.0102/0537.html
> >
> >Coincidentally, I, too, have been writing about forcible sex offenses which
> >are not officially classified as rape or attempted rape.
> >
> >See Will Michele TAKE ACTION?/Gang rape is kind of an understatement...
> >http://groups.yahoo.com/group/chiro-list/message/1073
> >
> >I am SURE these forcible sex offenses occur ROUTINELY on the University of
> >Minnesota campus - indeed - I am quite sure they are being TAUGHT to
> >University of Minnesota medical students - just like they were taught back
> >when Dr. Woolley was a medical student.
> >
> >CLEARLY - the forcible sex offenses to which I refer are quite rape-like -
> >involving as they do routine mass slashing of vaginas and penises.
> >
> >Being a doctor of chiropractic (DC), I am especially interested in the
> >routine vagina slashing because it is associated with routine GRUESOME
> >spinal manipulation of babies at birth - with MDs sometimes actually ripping
> >spinal nerves out of tiny spinal cords. (It is a little known fact that - as
> >MDs gripe about DELICATE spinal adjustments performed by DCs - MDs are
> >performing massive numbers of GRUESOME spinal manipulations on babies.)
> >
> >I am currently waiting for a reply from one of the world's top
> >neuroscientists regarding whether he thinks American MDs are "lying" or
> >lying to perpetuate their mass routine rape-like behaviors...
> >
> >Rama: Are MDs 'lying' or lying? Phantom fetal heads!
> >http://groups.yahoo.com/group/chiro-list/message/1090
> >
> >When I began discussing American medicine's mass routine rape-like behaviors
> >on an international e-mail list for obstetricians and gynecologists (which,
> >incidentally, is where I read of Dr. Woolley's rape article)...
> >
> >Dr. Woolley initially pretended he wasn't comfortable with my censorship...
> >
> >"Ignoring is a much better option, IMHO. Unless there is an *extremely* high
> >threshold for cutting somebody off (with the exception of non-professionals
> >who don't belong by the list's charter), it has a slippery slope tendency to
> >call for silencing those we disagree with."
> >http://forums.obgyn.net/ob-gyn-l/OBGYNL.9707/0169.html
> >
> >But then - after I was censored (I can still *receive* OBGYNL posts - I just
> >can't post) - Dr. Woolley said I had been censored "with good reason."
> >
> >He wrote:
> >
> >"It's easiest just to ignore him. Your post here mentioning his name (as
> >well as mine here in reply) will undoubtedly generate more output from him,
> >always with the same basic content. The man is a few fries short of a Happy
> >Meal, if you know what I mean.As far as know, he's the only person ever to
> >be barred from this list. And with good reason. If you see his name, delete
> >sight unseen. He will beg, cajole, and challenge you to forward his stuff to
> >the list, since he is blocked from doing so himself. Please don't."
> >http://forums.obgyn.net/ob-gyn-l/OBGYNL.9812/0788.html
> >
> >Dr. Woolley - the gun-toting ostensible anti-rape activist - is actually an
> >indirect promoter of mass routine rape-like MD behaviors - many of which are
> >occurring right there on the University of Minnesota campus!
> >
> >Remember:
> >
> >"It is the mission of the [University of Minnesota] Academic Health Center
> >to be the leader in ethical, innovative and efficient discovery and
> >dissemination of knowledge to enhance the health of the women of Minnesota,
> >the nation and the world."
> >http://www.med.umn.edu/obgyn/
> >
> >Routine slashing of vaginas and routine gruesome manipulation of babies'
> >spines does NOT "enhance the health of women" - or babies... Some of them
> >DIE from this mass routine rape-like behavior!
> >
> >Will the Minnesota Daily help University of Minnesota's Academic Health
> >Center accomplish its Mission?
> >
> >--
> >Todd D. Gastaldo, D.C.
> >8948 SW Barbur Blvd
> >Box 6
> >Portland, OR 97219
> >FAX (815) 366-2814
> >TEL (503) 640-0456
> >gastaldo@gte.net
> >http://groups.yahoo.com/group/chiro-list
> >
> >Copied to the following persons at Minnesota Daily...
> >
> >Editor in Chief Julia Grant Newsroom Staff grant@daily.umn.edu
> >Ext.3020
> >Managing Editor Sarah Mckenzie Newsroom Staff smckenzie@daily.umn.edu
> >Ext.3200
> >News Editor Liz Bogut Newsroom Staff ebogut@daily.umn.edu
> >Ext.3201
> >Associate Editor - Administration Desk Mark Baumgarten Newsroom Staff
> >mbaumgarten@daily.umn.edu
> >Ext.3225
> >Associate Editor - Campus Desk Craig Gustafson Newsroom Staff
> >cgustafson@daily.umn.edu
> >Ext.3222
> >Associate Editor - City Desk Erin Ghere Newsroom Staff eghere@daily.umn.edu
> >Ext.3214
> >Copy Chief Andrew Pritchard Newsroom Staff apritchard@daily.umn.edu
> >Ext.3219
> >Freelance Coordinator Megan Boldt Newsroom Staff mboldt@daily.umn.edu
> >Ext.3235
> >Sports Editor Josh Linehan Newsroom Staff jlinehan@daily.umn.edu
> >Ext.3241
> >Business Editor Peter Frost Newsroom Staff pfrost@daily.umn.edu
> >Ext.3215
> >Copy Desk Editor Jessica Kramer Newsroom Staff kramer@daily.umn.edu
> >Ext.3265
> >Copy Desk Editor Monica LaBelle Newsroom Staff mlabelle@daily.umn.edu
> >Ext.3265
> >Senior Reporter Patrick Hayes Newsroom Staff phayes@daily.umn.edu
> >Ext.3211
> >Senior Reporter Tess Langfus Newsroom Staff tlangfus@daily.umn.edu
> >Ext.3217
> >Senior Reporter Todd Milbourn Newsroom Staff tmilbourn@daily.umn.edu
> >Ext.3234
> >Senior Reporter Mike Wereschagin Newsroom Staff wereschagin@daily.umn.edu
> >Ext.3226
> >Sports Reporter John Carter Newsroom Staff jcarter@daily.umn.edu
> >Ext.3244
> >Sports Reporter Michael Dougherty Newsroom Staff mdougherty@daily.umn.edu
> >Ext.3245
> >Sports Reporter Mark Heller Newsroom Staff mheller@daily.umn.edu
> >Ext.2246
> >Sports Reporter Sarah Mitchell Newsroom Staff smitchell@daily.umn.edu
> >Ext.3242
> >Sports Reporter Monica Wright Newsroom Staff mwright@daily.umn.edu
> >Ext.3246
> >Staff Reporter Mickie Barg Newsroom Staff mbarg@daily.umn.edu
> >Ext.
> >Staff Reporter Justin Costley Newsroom Staff jcostley@daily.umn.edu
> >Ext.3231
> >Staff Reporter George Fairbanks Newsroom Staff gfairbanks@daily.umn.edu
> >Ext.
> >Staff Reporter Pete Johnson Newsroom Staff pjohnson@daily.umn.edu
> >Ext.
> >Staff Reporter Sam Kean Newsroom Staff skean@daily.umn.edu
> >Ext.
> >Staff Reporter Jess Thompson Newsroom Staff jthompson@daily.umn.edu
> >Ext.
> >Staff Reporter Fabiana Torreao Newsroom Staff ftorreao@daily.umn.edu
> >Ext.3212
> >Staff Reporter Seth Woehrle Newsroom Staff swoehrle@daily.umn.edu
> >Ext.
> >World and Nation Editor Philip Hanson Newsroom Staff phanson@daily.umn.edu
> >Ext.3201
> >Opinions/Editorials
> >
> >Position Name Department e-mail/Extension
> >Editorial Editor Bryan Keogh Opinions/Editorials bkeogh@daily.umn.edu
> >Ext.3283
> >Opinions Editor Samantha Pace Opinions/Editorials space@daily.umn.edu
> >Ext.3281
> >Columnist Christopher Schaffer Opinions/Editorials cschaffer@daily.umn.edu
> >Ext.3281
> >Editorial Board David Gustafson Opinions/Editorials dgustafson@daily.umn.edu
> >Ext.3283
> >Editorial Board K.C. Howard Opinions/Editorials khoward@daily.umn.edu
> >Ext.3283
> >Editorial Board Jende Huang Opinions/Editorials jhuang@daily.umn.edu
> >Ext.3283
> >Editorial Cartoonist Monica LaBelle Opinions/Editorials
> >mlabelle@daily.umn.edu
> >Ext.3283
> >Editorial Cartoonist Nate Melcher Opinions/Editorials nmelcher@daily.umn.edu
> >Ext.3283
> >Editorial Cartoonist Pete Wagner Opinions/Editorials pwagner@daily.umn.edu
> >Ext.3283
> >
> >IMPORTANT NOTE: I'm not licensed anywhere - by choice...
> >
> >Back around 1990 when I *was* licensed (and had been for 10 years) - a man
> >claiming to be Michael Schroeder, Esq. (attorney for the California Board of
> >Chiropractic Examiners in a lawsuit
> >brought by 10 MD-obstetricians and others) - told me it was not within my
> >scope of practice as a California licensed DC to inform women regarding
> >grisly
> >MD-obstetrician birth practices.
> >
> >Coincidentally, a Michael Schroeder, Esq. - former chairman of
> >the California Republican Party - sued me for one million dollars for
> >defamation - for claiming that he improperly used hundreds of thousands in
> >DC licensing fees to defend Rule 302, a regulatory definition of
> >chiropractic that he had written - and which had been publicly pilloried as
> >being "unlawful" by a
> >former assistant DA/public defender.
> >
> >Incredibly, in taking *me* to task for indicating publicly that Mr.
> >Schroeder's Rule 302 was unlawful, Acupuncture Today editor Donald M.
> >Petersen, Jr. "forgot" to mention that he had printed Attorney Prescott
> >doing the same thing!
> >(For details, go to http://groups.google.com and search "Prescott Schroeder
> >Rule 302" )
> >
> >FACT: 10-MD-obstetricians were in part the cause of Mr. Schroeder earning
> >hundreds of thousands of dollars if DC licensing fees in the Rule 302
> >matter...
> >
> >QUESTION: WHY isn't "chiropractic" attorney Schroeder helping me stop
> >routine gruesome spinal manipulation by MDs who are obviously lying and
> >closing birth canals?
> >
> >Posted to the usenet (misc.health.alternative, sci.med, misc.kids.pregnancy)
> >Before we teach more MDs how to manipulate the spines of adults"
> >http://www.chiroweb.com/archives/18/26/21.html
> >
> >..maybe we should stop MDs from GRUESOMELY manipulating the spines of
> >babies?
> >(Go to http://groups.google.com and search "Pardons in advance for MDs" )
> >
> >Copied to Acupuncture Today editor Donald M. Petersen, Jr at Don@DCMedia.com
> >and Don@MPAmedia.com
> >
> >Copied to Oregon Board of Chiropractic Examiners/OBCE Exec. Dir. Dave
> >McTeague via oregon.obce@state.or.us
> >
> >For details on OBCE Exec. Dir. McTeague's foot-dragging, go to
> >http://groups.google.com - search "OBCE/Whether to x-ray Medicare
> >patients/Atlas Shrugs"
> >
>
> --
> art fougner, md
>
> A series of 1000 cases begins with but a single anecdote.
>
> ------------------------------
>
> ------------------------------
> Date: Tue, 20 Feb 2001 16:43:19 -0700
> ------------------------------
> From: "G. P. Rodriguez" <geraldpr@cybermesa.com>
> To: ob-gyn-l@obgyn.net
> Subject: Fwd: Re: Doctor convicted of manslaughter
> Message-ID: <5.0.2.1.0.20010220163746.00a1d320@cybermesa.com>
> Mime-Version: 1.0
> Content-Type: text/plain; charset="us-ascii"; format=flowed
>
> >
> >Subject: Re: Doctor convicted of manslaughter
> >X-Comment: Obstetrics & Gynecology for MEDICAL PROFESSIONALS ONLY
> >
> >In a message dated 2/20/01 15:42, jth@springnet1.com writes:
> >
> ><< Prosecutors claim Biskind, 75, and Stuart-Schadoff, 63, caused the death
> >by ignoring sonograms showing that Herron, 33, had a more developed pregnancy
> >and provided little care for the patient as she bled
> >heavily >>
> >
> >So does purposefully ignoring or hiding the more advanced pregnancy and
> >abandoning a patient in extremis constitute a CIVIL case, i.e. malpractice,
> >or a CRIMINAL offense?
> >
> >Any opinions?
> >
> >Joe P.
>
> I suppose the answer to Joe's question lies in the details of the
> case. It's probably a given that this case has long ago triggered the
> malpractice threshold as well as gotten the attention of the licensing
> board in AZ.
>
> Gerald P. Rodriguez, M.D., FACOG
>
> "He who hesitates is last."--Mae West
>
> ------------------------------
>
> ------------------------------
> Date: Tue, 20 Feb 2001 19:00:16 -0500
> ------------------------------
> From: Paul Prior MD <pprior@clover.net>
> To: ob-gyn-l@obgyn.net
> Subject: Re: UMNs Woolley perpetuates mass rape-like behavior (fwd)
> Message-ID: <66169t8231hlbk0rcautmjh7si8hjamobj@4ax.com>
> MIME-Version: 1.0
> Content-Type: text/plain; charset=us-ascii
> Content-Transfer-Encoding: 7bit
>
> On Tue, 20 Feb 2001 17:04:04 -0600, DoctorJoe@aol.com wrote:
>
> >In a message dated 2/20/01 16:31, wooll005@tc.umn.edu writes:
> ><< Routine slashing of vaginas and routine gruesome manipulation of babies'
> >spines does NOT "enhance the health of women" - or babies... Some of them
> >DIE from this mass routine rape-like behavior! >>
> >I guess I'm missing something. How are we manipulating babies' spines? By
> >delivering them? What are supposed to do, let them fall out on their heads?
> >THAT'LL cause some spinal problems...!
>
> If I recall from his earlier rantings... err I mean postings, I think
> the premise is that by doing dorsal lithotomy position deliveries the
> maternal sacrum is gouging into the baby's cervical spine and causing
> permanent injury to untold numbers of babies. Is that about right,
> Bob?
>
> --
> Paul Prior MD
> Coshocton, OH
> Solo Practice
> OB/GYN, FACOG
>
> ------------------------------
>
> ------------------------------
> Date: Tue, 20 Feb 2001 18:55:44 -0600 (CST)
> ------------------------------
> From: ainsron@msn.com
> To: OB-GYN-L@OBGYN.NET
> Subject: Re: Doctor convicted of manslaughter
> Message-ID: <200102210055.SAA10364@mail.medispecialty.com>
>
> It's already happened in California too. Doc performing abortions
> locally had a client die after perforation and hemorrhage. He was
> convicted of second degree murder.
> >
> >Indeed a very slippery slope. Scary precedent.
> >
> >--
> >Paul Prior MD
> >Coshocton, OH
> >Solo Practice
> >OB/GYN, FACOG
> >
>
> --
> Ronald E. Ainsworth, MD
>
> ------------------------------
>
> ------------------------------
> Date: Tue, 20 Feb 2001 19:02:36 -0600 (CST)
> ------------------------------
> From: jablon@empire.net (Melinda Jablonski)
> To: OB-GYN-L@OBGYN.NET
> Subject: OB CALCULATOR
> Message-ID: <200102210102.TAA13768@mail.medispecialty.com>
>
> Several months ago I came across a shareware program written by an
> ob/gyn that will calculate the dates a patient will need to have certain
> testing done during her pregnancy. At this time I am unable to locate
> the program on the web and thought someone could guide me in the right
> direction. Thank you in advance for your time.
> Melinda Jablonski, Office Manager
>
> ------------------------------
>
> ------------------------------
> Date: Tue, 20 Feb 2001 19:19:55 -0600 (CST)
> ------------------------------
> From: ainsron@msn.com
> To: OB-GYN-L@OBGYN.NET
> Subject: Fri: relationships with the opposite sex
> Message-ID: <200102210119.TAA22161@mail.medispecialty.com>
>
> Sorry I didn't have this in time for Valentine's Day, would have made a
> good card.
>
> Romance Mathematics
>
> Smart man + smart woman = romance
> Smart man + dumb woman = affair
> Dumb man + smart woman = marriage
> Dumb man + Dumb woman = pregnancy
>
> Shopping Math
>
> A man will pay $2 for a $1 item he needs.
> A woman will pay $1 for a $2 item she doesn’t need.
>
> General equations & statistics
>
> A woman worries about the future until she gets a husband.
> A man never worries about the future until he gets a wife.
> A successful man is one who makes more money than his wife can spend.
> A successful woman is one who can find such a man.
>
> Happiness
>
> To be happy with a man, you must understand him a lot and love him
> little.
> To be happy with a woman, you must love her a lot and not try to
> understand her at all.
>
> Memory
>
> Any married man should forget his mistakes; there’s no use in two people
> remembering the same thing.
>
> Appearance
>
> Men wake up as good-looking as they went to bed.
> Women somehow deteriorate during the night.
>
> Propensity to change
>
> A woman marries a man expecting he will change, but he doesn’t.
> A man marries a woman expecting that she won’t change, and she does.
>
> Discussion Technique
>
> A woman has the last word in any argument.
> Anything a man says after that is the beginning of a new argument.
>
> --
> Ronald E. Ainsworth, MD
>
> ------------------------------
>
> ------------------------------
> Date: Tue, 20 Feb 2001 21:27:07 -0600 (CST)
> ------------------------------
> From: richard.chudacoff@medispecialty.com (Richard Chudacoff, MD)
> To: OB-GYN-L@OBGYN.NET
> Subject: RELATIVE RISK
> Message-ID: <200102210327.VAA17018@mail.medispecialty.com>
>
> I have a friend (believe it or not) who is a 41 year old G3 P2 with a
> greater than 15 year history of IDDM. I don't believe she has any
> renal, eye, cardiac, or other end-organ problems, and she did mangae to
> get pregnant unintentially, while her Hbg A1C what slightly elevated.
> Currently she is at 12 weeks EGA and called me for advice.
>
> She has been offered a CVS for tomorrow (the last day her perinatologist
> would do it) and asked me my thoughts. While talking with her, we
> discussed the nuchal translucency test, and I came to ponder this
> question: What would be the chance of having an abnormal fetus with a
> normal 11-12 week nuchal translucency study, normal 15 week maternal
> serum alphafetoprotein and a normal 18 week level ll ultrasound? Would
> the false negative rate (i.e. the chance of having an abnormal fetus
> with normal testing in all three areas) approach that of an
> amniocentesis at 15 or 16 weeks? Would the rate of diagnosing an
> abnormal fetus using the combination of these three non-or-minimally
> invasive tests approach than of the invasive amniocentesis? True, the
> results of the amnio would be received sooner than waiting for the 18
> week ultrasound, but the risk of loss would be greater, too.
>
> Anyone out there with a mathamatical background that can answer this?
>
> Thanks
>
> Rick
>
> --
> Richard Chudacoff, MD
> Chudacoff Obstetrics & Gynecology, PLLC
> Sugar Land, TX
>
> ------------------------------
>
> ------------------------------
> Date: Tue, 20 Feb 2001 22:34:26 -0600 (CST)
> ------------------------------
> From: evsono@pipeline.com (art fougner, md)
> To: OB-GYN-L@OBGYN.NET
> Subject: Re: humbled by an ectopic
> Message-ID: <200102210434.WAA08019@mail.medispecialty.com>
>
> Mats -
>
> that was titer of 30,000 as a critical titer for cardiac activity, not
> demonstration of iug sac.
>
> sorry if that was not clear.
>
> art
>
> At Wed, 21 Feb 2001, Mats O. Bergstrom wrote:
> >
> >Art wrote:
> >
> >>a bit about HCG titers - once had a patient with no evidence of
> >>intrauterine pregnancy at a titer of 30,000.......ubsequent ultrasound
> >>revealed the presence of intrauterine triplets - easily explaining the
> >>hcg titer.
> >
> >Yes, but that was some years ago and/or an abdominal exam, I guess?
> >
> >The latest table I saw showing levels for finding a sac/sacs in utero
> >at vaginal exam:
> >
> >simplex 1000 (800 in some tables)
> >duplex 1600
> >triplex 3400
> >quadruplex 9400
> >
> >Mats Bergstrom, MD
> >Ob Gyn
> >South Hospital
> >Stockholm
>
> --
> art fougner, md
>
> A series of 1000 cases begins with but a single anecdote.
>
> ------------------------------
>
> ------------------------------
> Date: Tue, 20 Feb 2001 23:38:00 EST
> ------------------------------
> From: DoctorJoe@aol.com
> To: ob-gyn-l@obgyn.net
> Subject: Re: humbled by an ectopic
> Message-ID: <8f.72b6684.27c4a028@aol.com>
> MIME-Version: 1.0
> Content-Type: text/plain; charset="US-ASCII"
> Content-Transfer-Encoding: 7bit
>
> In a message dated 2/20/01 10:36:13 PM, evsono@pipeline.com writes:
>
> << that was titer of 30,000 as a critical titer for cardiac activity, not
> demonstration of iug sac.
>
> sorry if that was not clear. >>
>
> So the point would be, if the titer was THAT high, and no sac or cardiac
> motion was visible, wouldn't you be nervous about gestational trophoblastic
> disease or an ovarian tumor?
>
> Joe P.
>
> ------------------------------
>
> ------------------------------
> Date: Tue, 20 Feb 2001 22:38:53 -0600 (CST)
> ------------------------------
> From: evsono@pipeline.com (art fougner, md)
> To: OB-GYN-L@OBGYN.NET
> Subject: Re: LATIVE RISK
> Message-ID: <200102210438.WAA09816@mail.medispecialty.com>
>
> would defer to Drs. Bombard and Roberts for the math but i'd suggest
> looking at this a different way. in Beryl Benacerraf's lab, they use a
> scoring system for their "genetic sonogram." age 40 or over achieves a
> score sufficient to warrant amnio without any sonar findings.
>
> art
>
> At Tue, 20 Feb 2001, Richard Chudacoff, MD wrote:
> >
> >I have a friend (believe it or not) who is a 41 year old G3 P2 with a
> >greater than 15 year history of IDDM. I don't believe she has any
> >renal, eye, cardiac, or other end-organ problems, and she did mangae to
> >get pregnant unintentially, while her Hbg A1C what slightly elevated.
> >Currently she is at 12 weeks EGA and called me for advice.
> >
> >She has been offered a CVS for tomorrow (the last day her perinatologist
> >would do it) and asked me my thoughts. While talking with her, we
> >discussed the nuchal translucency test, and I came to ponder this
> >question: What would be the chance of having an abnormal fetus with a
> >normal 11-12 week nuchal translucency study, normal 15 week maternal
> >serum alphafetoprotein and a normal 18 week level ll ultrasound? Would
> >the false negative rate (i.e. the chance of having an abnormal fetus
> >with normal testing in all three areas) approach that of an
> >amniocentesis at 15 or 16 weeks? Would the rate of diagnosing an
> >abnormal fetus using the combination of these three non-or-minimally
> >invasive tests approach than of the invasive amniocentesis? True, the
> >results of the amnio would be received sooner than waiting for the 18
> >week ultrasound, but the risk of loss would be greater, too.
> >
> >Anyone out there with a mathamatical background that can answer this?
> >
> >Thanks
> >
> >Rick
> >
> >--
> >Richard Chudacoff, MD
> >Chudacoff Obstetrics & Gynecology, PLLC
> >Sugar Land, TX
> >
>
> --
> art fougner, md
>
> A series of 1000 cases begins with but a single anecdote.
>
> ------------------------------
>
> ------------------------------
> Date: Tue, 20 Feb 2001 22:41:59 -0600 (CST)
> ------------------------------
> From: evsono@pipeline.com (art fougner, md)
> To: OB-GYN-L@OBGYN.NET
> Subject: Re: UMNs Woolley perpetuates mass rape-like behavior
> Message-ID: <200102210441.WAA11772@mail.medispecialty.com>
>
> huzzah - florida's butterfly ballot explained!
>
> as an aside, i wonder why professor gastaldo did not alert gov. mind?
> and can we get him off the xfl broadcasts please???
>
> art
>
> At Tue, 20 Feb 2001, Paul Prior MD wrote:
> >
> >On Tue, 20 Feb 2001 17:04:04 -0600, DoctorJoe@aol.com wrote:
> >
> >>In a message dated 2/20/01 16:31, wooll005@tc.umn.edu writes:
> >><< Routine slashing of vaginas and routine gruesome manipulation of babies'
> >>spines does NOT "enhance the health of women" - or babies... Some of them
> >>DIE from this mass routine rape-like behavior! >>
> >>I guess I'm missing something. How are we manipulating babies' spines? By
> >>delivering them? What are supposed to do, let them fall out on their heads?
> >>THAT'LL cause some spinal problems...!
> >
> >If I recall from his earlier rantings... err I mean postings, I think
> >the premise is that by doing dorsal lithotomy position deliveries the
> >maternal sacrum is gouging into the baby's cervical spine and causing
> >permanent injury to untold numbers of babies. Is that about right,
> >Bob?
> >
> >--
> >Paul Prior MD
> >Coshocton, OH
> >Solo Practice
> >OB/GYN, FACOG
> >
>
> --
> art fougner, md
>
> A series of 1000 cases begins with but a single anecdote.
>
> ------------------------------
>
> ------------------------------
> Date: Tue, 20 Feb 2001 23:53:04 -0500
> ------------------------------
> From: Paul Prior MD <pprior@clover.net>
> To: ob-gyn-l@obgyn.net
> Subject: Re: Doctor convicted of manslaughter
> Message-ID: <0bi69tc91k3g1aocsmh26gh8dluu7t0vk9@4ax.com>
> MIME-Version: 1.0
> Content-Type: text/plain; charset=us-ascii
> Content-Transfer-Encoding: 7bit
>
> On Tue, 20 Feb 2001 18:59:00 -0600, ainsron@msn.com wrote:
>
> >It's already happened in California too. Doc performing abortions
> >locally had a client die after perforation and hemorrhage. He was
> >convicted of second degree murder.
>
> I find it quite interesting that these cases are brought against
> people doing politically unpopular procedures. It seems every case
> that I've heard about manslaughter charges being brought had something
> to do with abortion.
>
> Anyone more familiar with the law know of any non-abortion related
> manslaughter charges based upon medical negligence?
>
> --
> Paul Prior MD
> Coshocton, OH
> Solo Practice
> OB/GYN, FACOG
>
> ------------------------------
>
> ------------------------------
> Date: Wed, 21 Feb 2001 01:13:41 -0500
> ------------------------------
> From: Rafael Haciski MD <haciski@earthlink.net>
> To: <ob-gyn-l@obgyn.net>
> Subject: Re: Interesting case - with questions!
> Message-ID: <B6B8C6C5.22BE%haciski@earthlink.net>
> Mime-version: 1.0
> Content-type: text/plain; charset="US-ASCII"
> Content-transfer-encoding: 7bit
>
> I agree with as brief a procedure as possible:
> ..close the defect only if bleeding, otherwise leave it alone (unless it's
> huge)
> ..hysterotomy to remove the dead fetus
>
> My question would be should one tie the tube on the pregnant horn to prevent
> recurrence, while in the abdomen??
>
> Rafael Haciski, MD FACOG
> Gynecology & Infertility Assoc.
> Baltimore MD
> http://www.ivf-md.com
>
> > From: "Braun, R. Daniel" <rbraun@iupui.edu>
> > Reply-To: ob-gyn-l@obgyn.net
> > Date: Tue, 20 Feb 2001 05:43:24 -0600
> > To: Multiple recipients of list OB-GYN-L <ob-gyn-l@forum.obgyn.net>
> > Subject: RE: Interesting case - with questions!
> >
> > Remove the pregnancy and Get out of Dodge. Re-evaluate in non pregnanct
> > state to determine best management of uterine anomaly.
> >
> > Dan
> >
> > -----Original Message-----
> > From: Griffiths Malcolm (RC9) Luton & Dunstable Hospital
> > TR[mailto:Malcolm.Griffiths@ldh-tr.anglox.nhs.uk]
> > Sent: Tuesday, February 20, 2001 3:49 AM
> > To: Multiple recipients of list OB-GYN-L
> > Subject: RE: Interesting case - with questions!
> >
> > Case of a colleague. PH prem labour at 24 weeks with NND at 17h. Normally
> > formed fetus. Investigations NAD.
> >
> > This time suffers IUFD at 21 weeks. Prior to that growth had been good.
> >
> > Attempted induction with Mefepristone, Gemeprost, misoprostol, Syntocinon.
> > Cervix remains closed.
> >
> > Various options discussed. Colleague now away on leave.
> >
> > Patient and I agreed to D&E. Given all above treatments I don't pretreat the
> > cervix or use my usual Dilapan.
> >
> > At EUA uterus feels ~ dates. Easily dilated to 17Hegar.
> >
> > As soon as instrumented recognised perforation. I'm really cross with myself
> > as I've never perforated at D&E before.
> >
> > Laparotomy (to deal with perforation and extract fetus by hysterotomy).
> >
> > At laparotomy findings - perforation of non-pregnant left uterine horn!
> > Pregnancy in rudimentary non-communicating right horn!!!
> >
> > What to do?
> >
> > **********************************************************************
> > This email and any files transmitted with it are confidential and
> > intended solely for the use of the individual or entity to whom they
> > are addressed. If you have received this email in error please notify
> > the system manager.
> >
> > This footnote also confirms that this email message has been swept by
> > MIMEsweeper for the presence of computer viruses.
> >
> > **********************************************************************
> >
>
> ------------------------------
>
> ------------------------------
> Date: Wed, 21 Feb 2001 07:59:56 -0000
> ------------------------------
> From: "Griffiths Malcolm (RC9) Luton & Dunstable Hospital TR" <Malcolm.Griffiths@ldh-tr.anglox.nhs.uk>
> To: "'ob-gyn-l@obgyn.net'" <ob-gyn-l@obgyn.net>
> Subject: RE: Post-sterilization hCG
> Message-ID: <cf1f0001ec7da5a32c2f5d1f39e8ab3c3a938c16@>
> MIME-Version: 1.0
> Content-Type: text/plain;
> charset="iso-8859-1"
>
> I'm sure you must be using different units for hCG to ours - what are they?
>
> If you have confirmed a pregnancy have you excluded an ectopic?
>
> If she got pregnant she has a patent tube and may conceive again.
> Contraception is indicated!
>
> -----Original Message-----
> From: Hugo D. Ribot Jr. [mailto:hribot@mindspring.com]
> Sent: 20 February 2001 17:06
> To: Multiple recipients of list OB-GYN-L
> Subject: Post-sterilization HCG
>
> 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!)
>
> **********************************************************************
> This email and any files transmitted with it are confidential and
> intended solely for the use of the individual or entity to whom they
> are addressed. If you have received this email in error please notify
> the system manager.
>
> This footnote also confirms that this email message has been swept by
> MIMEsweeper for the presence of computer viruses.
>
> **********************************************************************
>
> ------------------------------
>
> Date: Wed, 21 Feb 2001 08:12:31 -0000
> From: "Griffiths Malcolm (RC9) Luton & Dunstable Hospital TR" <Malcolm.Griffiths@ldh-tr.anglox.nhs.uk>
> To: "'ob-gyn-l@obgyn.net'" <ob-gyn-l@obgyn.net>
> Subject: RE: Interesting case - with questions!
> Message-ID: <50809084a15967f61e43edc5fa49fe673a938c18@>
> MIME-Version: 1.0
> Content-Type: text/plain;
> charset="iso-8859-1"
>
> My first thought was to close the defect, do a hysterotomy and then close
> the hysterotomy. As the patient had not consented and it was an unusual
> case, I took the precaution of getting a second opinion from a colleague,
> who agreed.
>
> I then noticed that the wall of the rudimentary horn was not
> contracting/retracting and the placental bed was VERY oozy. I also was
> unable to demonstrate any communication from that horn with the cervix.
> Accordingly I couldn't stop bleeding, the blood and lochia had no way to
> drain. The only significant connection between the rudimentary horn and the
> other horn was at the level of the fundus of the latter (kind of where the
> tube and round ligament would insert).
>
> Accordingly my colleague and I both thought it best to remove the
> rudimentary horn - which I did.
>
> Speaking to the patient and her family afterwards I learnt that she has
> always had very severe dysmen and wonder whether this was due to
> menstruation in the non-communicating horn.
>
> The fundal defect on the "normal side" was small but bleeding enough to
> warrant a figure of eight suture with Monocryl.
>
> Patient and family were delighted with the care and the actions done without
> her consent.
>
> -----Original Message-----
> From: Rafael Haciski MD [mailto:haciski@earthlink.net]
> Sent: 21 February 2001 06:02
> To: Multiple recipients of list OB-GYN-L
> Subject: Re: Interesting case - with questions!
>
> I agree with as brief a procedure as possible:
> .close the defect only if bleeding, otherwise leave it alone (unless it's
> huge)
> .hysterotomy to remove the dead fetus
>
> My question would be should one tie the tube on the pregnant horn to prevent
> recurrence, while in the abdomen??
>
> Rafael Haciski, MD FACOG
> Gynecology & Infertility Assoc.
> Baltimore MD
> http://www.ivf-md.com
>
> > From: "Braun, R. Daniel" <rbraun@iupui.edu>
> > Reply-To: ob-gyn-l@obgyn.net
> > Date: Tue, 20 Feb 2001 05:43:24 -0600
> > To: Multiple recipients of list OB-GYN-L <ob-gyn-l@forum.obgyn.net>
> > Subject: RE: Interesting case - with questions!
> >
> > Remove the pregnancy and Get out of Dodge. Re-evaluate in non pregnanct
> > state to determine best management of uterine anomaly.
> >
> > Dan
> >
> > -----Original Message-----
> > From: Griffiths Malcolm (RC9) Luton & Dunstable Hospital
> > TR[mailto:Malcolm.Griffiths@ldh-tr.anglox.nhs.uk]
> > Sent: Tuesday, February 20, 2001 3:49 AM
> > To: Multiple recipients of list OB-GYN-L
> > Subject: RE: Interesting case - with questions!
> >
> > Case of a colleague. PH prem labour at 24 weeks with NND at 17h. Normally
> > formed fetus. Investigations NAD.
> >
> > This time suffers IUFD at 21 weeks. Prior to that growth had been good.
> >
> > Attempted induction with Mefepristone, Gemeprost, misoprostol, Syntocinon.
> > Cervix remains closed.
> >
> > Various options discussed. Colleague now away on leave.
> >
> > Patient and I agreed to D&E. Given all above treatments I don't pretreat
> the
> > cervix or use my usual Dilapan.
> >
> > At EUA uterus feels ~ dates. Easily dilated to 17Hegar.
> >
> > As soon as instrumented recognised perforation. I'm really cross with
> myself
> > as I've never perforated at D&E before.
> >
> > Laparotomy (to deal with perforation and extract fetus by hysterotomy).
> >
> > At laparotomy findings - perforation of non-pregnant left uterine horn!
> > Pregnancy in rudimentary non-communicating right horn!!!
> >
> > What to do?
> >
> > **********************************************************************
> > This email and any files transmitted with it are confidential and
> > intended solely for the use of the individual or entity to whom they
> > are addressed. If you have received this email in error please notify
> > the system manager.
> >
> > This footnote also confirms that this email message has been swept by
> > MIMEsweeper for the presence of computer viruses.
> >
> > **********************************************************************
> >
>
> ------------------------------
>
> ------------------------------
> End of OB-GYN-L Digest 1379
> ------------------------------
> ***************************
