Re: Thrombophylia and recurrent abortions
From: art fougner, md (evsono@pipeline.com)
Tue Jul 2 11:22:03 2002
is that a surprise Ashley? look at malpractice trials - it's about the
quality of the infomercial not the quality of the product.
art
At Tue, 2 Jul 2002, D. Ashley Hill, MD wrote:
>
>Recently a patient requested confirmation that the "dose" of
>progesterone cream she was using was adequate for "fetal support" in the
>first trimester. She has no prior miscarriage history, and has no
>evidence of luteal phase defect. She told me "everybody knows that 70%
>of miscarriages are due to lack of progesterone" so she and her friends
>take this over-the-counter preparation to prevent miscarriage. I
>explained that inadequate progesterone was a possible cause of about 5%
>of miscarriages, and that progesterone supplementation is a
>controversial subject. She didn't buy it, and decided to increase the
>amount. Once again, inadequate or incorrect information leads to poor
>consumer choices.
>
>Ashley
>
>>-----Original Message-----
>>From: Dr. Rupak Ranjan Roy [mailto:rupakroy@vsnl.com]
>>Sent: Monday, July 01, 2002 9:13 PM
>>To: Multiple recipients of list OB-GYN-L
>>Subject: Re: Thrombophylia and recurrent abortions
>>
>>I agree with Dr. Raymond about the cause of first trimester
>>miscarriages.
>>So, why this gonadotrophin and progestogen business? These are not known
>>to
>>be helpful. But, in our country (and I suspect Egypt is no exception)
>>the
>>pharmaceutical companies promote these drugs vigorously and
>>unfortunately a
>>majority of the doctors also prescribe them at the slightest hint of a
>>miscarriage. This has gone so much out of hand that nowadays patients
>>sometimes demand that she be given injections to prevent miscarriage. I
>>now
>>have a patient in her third pregnancy with two previous early
>>miscarriages,
>>who has started to bleed. The ultrasound scan has showed a viable fetus
>>and
>>I am just reassuring her. But she phones me every night and asks for
>>something to be given to her (something that was prescribed to her
>>friend
>>with a good outcome). This way wrong concepts can take over.
>>I personally never prescribe progestogen support or gonadotrophins. The
>>argument I use with the patient is that if these drugs ARE helpful, then
>>all
>>you are doing is continuing with a chromosomally abnormal pregnancy.
>>
>>Dr. Rupak Ranjan Roy
>>MRCOG
>>
>>>>>----- Original Message -----
>>From: "Steve & Eryl Raymond" <eryl@intekom.co.za>
>>To: "Multiple recipients of list OB-GYN-L"
>><ob-gyn-l@mail.medispecialty.com>
>>Sent: Monday, July 01, 2002 3:03 PM
>>Subject: Re: Thrombophylia and recurrent abortions
>>
>>> Can you give evidence either in the literature or from studies you
>>have
>>done to
>>> support the opinion that most 1st trimester losses are due to
>>deficient
>
>--
>D. Ashley Hill, MD
>Associate Director
>Department of Obstetrics and Gynecology
>Florida Hospital Family Practice Residency
>Orlando, Florida
>
--
art fougner, md
ich bin ein New Yorker
