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Re: Follow up of the ascitis case and new oneFrom: Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C. (johnprov@sympatico.ca)Wed Sep 22 15:03:53 2004
At Wed, 22 Sep 2004, Ricardo Savaris wrote: > >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 > Minera Intrauterine device this , may not prevent ovualtion very well but at least her periods will be lite she may even have amenorrehea after a few months.
--
Take care, John
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