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Re: Case / question to the list: PLEASE LET ME KNOW YOUR OPNIONSFrom: Braun, R. Daniel (rbraun@iupui.edu)Mon Dec 22 04:54:33 2003
48 hours. Dan -----Original Message----- From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Brickster0@aol.com Sent: Sunday, December 21, 2003 7:59 PM To: Multiple recipients of list OB-GYN-L Subject: Case / question to the list: PLEASE LET ME KNOW YOUR OPNIONS Listers: I'm looking for any objective opinion for a difference of agreement with another physician / possible lurker on the list: 33 y/o wf G5P2022 with 18mth of unexplained infertility arrives for 1st ob visit 8.5 weeks by dates but unsure LMP. Positive home beta about a week ago per pt. No risk factors for ectopic except unexplained infertility. Pt arrives on a Thursday. Sono by MD on a Medison 530D (a relatively good machine) reveals no IUP; adenexal mass by real time sono reveals adenexal mass that sonographically is a simple cyst with a sono-dense mass which I responded "did that mass have heart beat?". It did not. Quant returns on Friday of 2300. I will say that in my experience, our labs in Atlanta do not match the literature in their discrepancy zone. Thus a quant of 2300 and no gestational sac is not unheard of. In my somewhat sue-happy state. I would like to see the pt the next day (Friday); my associate states he would ideally see the pt 48hrs later, but since that is a Saturday he will wait until Monday. I don't think that is appropriate. Is there anyone out there that can convince me I'm wrong? I have learned a great deal from the list members and I would like some objective insight into a possibly disastrous outcome. Please tell me your opinions; however, I can tell you the outcome. I saw the pt the next day in the office (with a GE 730) and saw an IUP with a gestational sac, and one week later the IUP had FHTs. Thank you all for your insight Brick BIlls MD Alpharetta, GA
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