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Re: Follow up of the ascitis case and new one From: Braun, R. Daniel (rbraun@iupui.edu) Thu Sep 23 11:53:47 2004 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: ainsron: "Re: Stem Cells" Previous message: dr.jefferson: "Re: Follow up of the ascitis case and new one" Maybe in reply to: Ricardo Savaris: "Follow up of the ascitis case and new one" The anti-coagulant that she is on can be dose adjusted to keep her anticoagulated even if she is on the hormones. R. Daniel Braun, MD "If everyone likes you, you're doing something wrong." Kinky Friedman I believe a self-righteous liberal or conservative with a cause is more dangerous than a Hell's Angel with an attitude. Andy Rooney -----Original Message----- From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of dr.jefferson Sent: Thursday, September 23, 2004 11:36 AM To: Multiple recipients of list OB-GYN-L Subject: Re: Follow up of the ascitis case and new one Dear Ricardo, I believe there's no way out. The use of hormones can modify the coagulation system. I suppose the follow up without medication is better. jefferson Delfino, MD Brazil > 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 > __________________________________________________________________________ Acabe com aquelas janelinhas que pulam na sua tela. -- __________________________________________________________________________ AntiPop-up UOL - É grátis! http://antipopup.uol.com.br/ Next message: ainsron: "Re: Stem Cells" Previous message: dr.jefferson: "Re: Follow up of the ascitis case and new one" Maybe in reply to: Ricardo Savaris: "Follow up of the ascitis case and new one"

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