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Re: Case / question to the list: PLEASE LET ME KNOW YOUR OPNIONS From: Richard Chudacoff, MD (rchudacoff@mylinuxisp.com) Tue Dec 23 10:08:48 2003 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Garry E. Siegel, M.D.: "OB: 4D ultrasound" Previous message: Richard Chudacoff, MD: "Re: HSV" In reply to: Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C.: "Re: 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" Another thing to remember is to treat the patient, not the labs or ultrasound. You have an asymptomatic patient with unsure dates. In my opinion, with this case, no signs of an ectopic, and no risk factors (if I remember correctly) I would wait. I don't think 48 or 96 hours makes a difference if she has no pain, and ectopic precautions are explained appropriately. IMHO -- Richard Chudacoff, MD War is an instrument entirely inefficient toward redressing wrong; and multiplies, instead of indemnifying losses. Thomas Jefferson -----Original Message----- From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net]On Behalf Of Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C. Sent: Monday, December 22, 2003 9:59 PM To: Multiple recipients of list OB-GYN-L Subject: Re: Case / question to the list: PLEASE LET ME KNOW YOUR OPNIONS 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 Next message: Garry E. Siegel, M.D.: "OB: 4D ultrasound" Previous message: Richard Chudacoff, MD: "Re: HSV" In reply to: Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C.: "Re: 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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