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Re: Case / question to the list: PLEASE LET ME KNOW YOUR OPNIONSFrom: Brickster0@aol.comTue Dec 23 04:05:14 2003
In a message dated 12/22/2003 10:59:45 PM Eastern Standard Time, johnprov@sympatico.ca writes: You basically took a patient who was asymptomtic and unsure of her dates and made her into an ectopic pregnancy because you had a Beta of 2300 and no sac on Vaginal U/S. I would say that would be the case in at least 30 -50% of cases where the pt is not sure of her dates ,you want to treat then all as ectopics then by all means go ahead. Whats the big deal with waiting 24 versus 72 hrs, I don't see any problem especially with no risk factors. I have seen ectopics with Beta's of 4000 that went on for weeks befrore rupturing and with Beta's of 50 that ruptured within 12 hrs. The most important things to consider are. 1.) Risk factors 2.) The patient's ability to understand the situation and be available for follow up.
--
Take care, John
John you are absolutey right, but it is waiting for 24 vs 96 hrs and I don't
think that is defensivle in court. D. Ashley and I trained in FL where we had
an "ectopic book" in the ER just for that reason. Robert and I were named in
a suit (both of us dropped, but another doc not) for not seeing a pt in time.
I would disagree that 18mth of explained infertility is not a concern for
possible tubal disease and thus a risk factor, but we can disagree.
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