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Re: Newly pregnant existing patients From: Dr. Ainsworth (ainsron@sbcglobal.net) Wed Feb 26 07:41:53 2003 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Lynn D. Montgomery, M.D.: "Re: Newly pregnant existing patients" Previous message: DoctorJoe@aol.com: "Re: Newly pregnant existing patients" In reply to: D. Ashley Hill, MD: "Re: Newly pregnant existing patients" Next in thread: Garry E. Siegel, M.D.: "Re: Newly pregnant existing patients" Reply: Garry E. Siegel, M.D.: "Re: Newly pregnant existing patients" Your main protection in this scenario is telling her that at the time of your encounter after the ectopic, PID, etc. that she is at great risk for another ectopic and if she ever thinks she is pregnant, she should be evaluated as soon as possible, especially if any spotting, pain,etc. and document it well in the chart. > >There is another potential issue. Let's say you have a patient in your >practice with a history of pelvic inflammatory disease, a prior ruptured >appendix, and has had 3 prior ectopic pregancies (all treated with MTX >or linear salpingostomy) who calls for an appointment. You're a popular >dude, so it's scheduled 2-3 weeks from now. In the meantime, she gets >abdominal pain and presents to the emergency department with a ruptured >ectopic requiring surgery and two units of blood. I can see a lawyer >blaming you because you did not call to warn her that she is at risk for >an ectopic, and make arrangements for serial HCG determinations and >sonography. > >In our 6-doctor practice a nurse sees all OB patients as soon as >possible after they call. She interviews them, signs the paperwork, >begins filling out the ACOG form, and obtains old records and labs. A >doctor then reviews the chart, and, if necessary, requests more >information or arranges appropriate follow-up. It works extremely well. >Best wishes, > >Ashley > >-- >D. Ashley Hill, MD >Associate Director >Department of Obstetrics and Gynecology >Florida Hospital Family Practice Residency >Orlando, Florida > Next message: Lynn D. Montgomery, M.D.: "Re: Newly pregnant existing patients" Previous message: DoctorJoe@aol.com: "Re: Newly pregnant existing patients" In reply to: D. Ashley Hill, MD: "Re: Newly pregnant existing patients" Next in thread: Garry E. Siegel, M.D.: "Re: Newly pregnant existing patients" Reply: Garry E. Siegel, M.D.: "Re: Newly pregnant existing patients"

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