Re: The pregnancy that wasn't
From: art fougner, md (evsono@pipeline.com)
Wed Jul 31 13:34:12 2002
never believe men
Hillary Clinton 2000.
At Wed, 31 Jul 2002, Bernard Cristalli wrote:
>
>"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
>>
--
art fougner, md
ich bin ein New Yorker
|
|
