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Re: Case / question to the list: PLEASE LET ME KNOW YOUR OPNIONSFrom: Garry E. Siegel, M.D. (garrys@mindspring.com)Sun Dec 21 20:15:27 2003
>Please tell me your opinions; however, I can tell you the outcome.&nbs ; I saw the pt the next day in the office (with a GE 730) and saw an IUP wi h a gestational sac, and one week later the IUP had FHTs. >Thank you all for your insight > >Brick BIlls MDAlpharetta, GA > >-------------------------------1072054638-- Brick: This case is more about logistics and legalities than patient care, with a dash of group relationships thrown in. Thursday--benign exam, empty uterus, ?mass. Friday--Quant returns as 2300 from Thursday I absolutely agree with your comment about HCGs and ultrasounds in Atlanta, and that you must put that objective data together with the clinical picture, including patient reliability, smarts, etc. I think that I would have done this: 1. Added a progesterone from Thursday, or actually have ordered one then. 2. Frankly, I think that I might NOT have scanned her before I had the quant HCG back--to avoid this scenario! Now, that said, it's Friday, so I would: 1. Call her and make sure she is OK. 2. Have her get a HCG Saturday at the hospital, and get the result that day (takes 1.5 hours). If high enough, have her scanned that day, as scans are also available on Saturday. However, your approach worked fine. Waiting until Monday potentially was a recipe for disaster. Garry
-- Garry E. Siegel, M.D. Private Practice Roswell, GA
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