Re: Ectopics
From: R. Daniel Braun (rd.braun@gmail.com)
Wed Dec 7 14:12:30 2005
And 80% are between 6 & 24.
On 12/6/05, Andrew Folley <agfolley@hotmail.com> wrote:
>
> I have used the cutoffs of 1500 for TVUS. If the HCG is above 1500 you
> should be seeing a gestational sac in the uterus. Keep in mind 5-10% of
> ectopics may have a "pseudogestational sac present. I have done
> endometrial curetagge in office to r/o chorionic villi and confirm the
> ectopic just like doing an endometrial biopsy but not a routine. Typically
> I
> would do it when I am suspicious of ectopic but HCG is low and falling or
> not rising as expected. Ie 700 and goes up to 800 in 48 hours. When HCG
> is
> lower than 1000-1500 I do as everyone else and repeat in 48 hours. The
> progesterone is still a useful tool in that <5 means not a viable
> preganancy
> and more than 25 means a good pregnancy.
>
> >From: "ainsron" <ainsron@sbcglobal.net>
> >Reply-To: ob-gyn-l@obgyn.net
> >To: Multiple recipients of list OB-GYN-L <ob-gyn-l@dns.obgyn.net>
> >Subject: RE: Ectopics
> >Date: Tue, 6 Dec 2005 09:50:26 -0600
> >
> >Never done one in that circumstance
> >
> >Ronald E. Ainsworth, MD, FACOG
> >
> >-----Original Message-----
> >From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Garry
> E.
> >Siegel, M.D.
> >Sent: Monday, December 05, 2005 7:47 PM
> >To: Multiple recipients of list OB-GYN-L
> >Subject: OB: Ectopics
> >
> >When faced with a "slam-dunk" unruptured, stable ectopic, say in your
> >office, and when you're considering methotrexate, what do listers do
> >about curettage? In this very hypothetical situation, let's make the HCG
> >3000, the ultrasound totally normal with a thin, well seen endometrial
> >stripe, and the exam normal, too.
> >
> >Many would simply give methotrexate here; I've seen that the diagnosis
> >of ectopic pregnancy is wrong here up to 40%.
> >
> >If you do a curettage, can you do it in the office? What type of
> >equipment is used, and what anesthesia, if any?
> >
> >Garry
> >
> >--
> >Garry E. Siegel, M.D.
> >Private Practice
> >Roswell, GA
> >
>
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--
R. Daniel Braun
Kinky for Governor
