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Follow up of the ascitis case and new oneFrom: Ricardo Savaris (rsavaris@hcpa.ufrgs.br)Wed Sep 22 12:16:30 2004
Dear all, The case with ascitis and cirrhosis is fine. We did not intervened again. We just managed clinically with diurtics and the drainage is 0. Good case to learn with, no ureter injuries. But, here we are again with another case: A 40 years old, who has a metallic heart valve. Her husband has vasectomy for 7 years. She is under anticoagulant INR: 2,4. She was submitted to a surgery yesterday due to an ovarian hemorrhagic cyst. She had a similar case before. Post op is fine, but I am concerned about her ovulation and the potential of future bleeding. I thought to give her Cerazette (desogestrel) or another progesterone only pill (norethisterone) to prevent ovulation and the possibility of bleeding. Nevertheless, desogestrel has an increased risk of venoembolism and norethisterone does not prevent ovulation as good as desogestrel. Any ideas how to managed it?
-- Ricardo Savaris, MD Porto Alegre - Brasil
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