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Re: Case / question to the list: PLEASE LET ME KNOW YOUR OPNIONS From: Charlie Chambers (cchamber@gorge.net) Mon Dec 22 10:42:20 2003 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Richard Chudacoff, MD: "Re: I'm back too and PCR testing" Previous message: ginny lee, CNM: "I'm back too and PCR testing" In reply to: Brickster0@aol.com: "Case / question to the list: PLEASE LET ME KNOW YOUR OPNIONS" Next in thread: Brickster0@aol.com: "Re: Case / question to the list: PLEASE LET ME KNOW YOUR OPNIONS" Given that the patient was asymptomatic, I think that either approach is reasonable depending on the reliability of this patient. What's more interesting is how only 24 hours later, you see a sac. How big was the gestational sac? Without any symptoms, I don't think I would have had the patient come in the very next day, unlikely to see a change in the ultrasound, and the beta won't be helpful. Therefore, I think the change in the ultrasound in just 24 hours is more of an issue. On Sunday, December 21, 2003, at 04:58 PM, Brickster0@aol.com wrote: > 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 > ************************************************************************ ****** Charlie Chambers Hood River, OR USA cchamber@alumni.rice.edu "All good things...come by grace, and grace comes by art, and art does not come easy." Norman Maclean ************************************************************************ ******* Next message: Richard Chudacoff, MD: "Re: I'm back too and PCR testing" Previous message: ginny lee, CNM: "I'm back too and PCR testing" In reply to: Brickster0@aol.com: "Case / question to the list: PLEASE LET ME KNOW YOUR OPNIONS" Next in thread: Brickster0@aol.com: "Re: Case / question to the list: PLEASE LET ME KNOW YOUR OPNIONS"

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