Re: The pregnancy that wasn't
From: Bernard Cristalli (bcrist@club-internet.fr)
Wed Jul 31 13:07:07 2002
"Never believe women!"
Joseph told us more than 20 centuries ago..
--
Bernard Cristalli MD AMACOG
AIHP - ACCA
Paris France
Bernard.Cristalli@CliniquedelEssonne.fr
http://www.CliniquedelEssonne.fr
http://www.obgyn.net/corresp/cristalli.htm
http://www.gyneweb.fr
'64 Mk2 3.8
> De : maggiela@rochester.rr.com (maggiecnm)
> Objet : The pregnancy that wasn't
>
> I apologize for the length of this post but it's a complicated story.
> Recently had a very strange thing happen and after beating myself black
> and blue I've decided to seek some opinions on this.
> A 42yo G3P1011 came to see my partner for a new OB visit. LMP 3/20, no
> bleeding since. Was 12 weeks by LMP at time of visit. Lady was thin,
> but had a large (2" wide) and thick vertical scar on the abdomen from a
> C/S 24 years ago.
> Hx was sig. for Hep B exposure, drug use, and an HIV+ partner. She had
> tested negative, but did not practice safe sex.
> On exam, my partner thought she heard FHT but it was intermittent at
> best.
> After discussion, we decided this patient was not appropriate for us to
> care for due to the high risk nauture of her pregnancy and that we would
> transfer her to the SCC clinic at the tertiary care center here.
> She came back to see me, and on exam,I felt what appeared to be a S=D
> uterus and an intermittent FHT. Pt agreed to be transferred. Partner
> was very angry with her for having disclosed his HIV status but seemed
> to accept my explanation that it was necessary for her and the baby's
> health to be honest.
> Now here is the kicker. 5 days later she presents at an Urgent care
> center after hurting her back. She tells them she is pregnant....they
> do a scan and no baby. (per the resident only a small "clot" in the
> uterus). No bleeding reported, no nothing. And a neg UPT.
> My partner is convinced that she aborted the baby the next day after I
> saw her but I do not think so....UPT would still be positive. In
> checking her records, it appears that she never had a UPT or HCG in our
> office but simply told the nurse she was pregnant and began prenatal
> care.
> Naturally I feel like a total idiot.....Was I feeling bowel or adhesions
> from the scar? And what did I hear? I have never had this happen before
> ( I do early u/s for any questions about dating or not hearing an FH
> when I think I should) and have felt lots of pregnant tummies in my
> time.
> I have not been able to get in touch with the patient (no phone) but am
> very concerned about her- we should find out why she hasn't had a period
> in 4 months and make sure there isn't something else wrong. And I want
> to get to the bottom of this.
> Any thoughts on this? I've already accused myself of everything from
> general stupidity on up so don't worry about hurting my feelings! I do
> believe there was an immaculate conception once but spontaneous
> disappearance?
>
> --
> Maggie, CNM
>
