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Re: OB: Missed Ab/Asherman's From: R. Daniel Braun (rd.braun@gmail.com) Fri Sep 23 23:11:07 2005 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: DoctorJoe@aol.com: "Re: FRI: Missed Ab/Asherman's" Previous message: DoctorJoe@aol.com: "Re: Necrotizing fasciitis post Cesarean" In reply to: Garry E. Siegel, M.D.: "OB: Missed Ab/Asherman's" Most common cause of Asherman's is (Unecessary) D&C in the late PPH patient who has Subinvolution of the Placental site. This phenomenon is best treated with uterotonics. I like Methergine. Dan On 9/23/05, Garry E. Siegel, M.D. <garrys@mindspring.com> wrote: > > 35 YO P0 at 12 weeks was found to have a missed Ab yesterday, measuring > 9+ weeks by CRL. > > D and C offered and discussed by another MD. The patient declined, > citing information from that physician claiming a 30% chance of > adhesions after surgery. > > The patient's overwhelming concern is to conceive and have a baby ASAP, > as she is 35, etc. > > She met with me today, and I told her that I suspect somehow the other > physician's message/discussion wasn't interpreted as intended, as she > cancelled her D and C due to the overwhelming concern regarding future > fertility based on that discussion. > > We discussed and I and D and C today--all went well. > > I'm going to research this, but any thoughts welcome, i.e. > > --what rate of future problems/infertility would you quote here? > --how would you contrast that awaiting a spontaneous abortion? > --if she awaits spontaneous abortion, how often do you tell patients > that they'll ultimately need a D and C? > > I'm doing a medline on this, too. > > Garry > > -- > Garry E. Siegel, M.D. > Private Practice > Roswell, GA > -- R. Daniel Braun Kinky for Governor Next message: DoctorJoe@aol.com: "Re: FRI: Missed Ab/Asherman's" Previous message: DoctorJoe@aol.com: "Re: Necrotizing fasciitis post Cesarean" In reply to: Garry E. Siegel, M.D.: "OB: Missed Ab/Asherman's"

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