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Re: Ectopics - New case From: Raymond Stephen (stephen.raymond@dhhs.tas.gov.au) Mon Jun 5 02:03:25 2006 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Gail Graham: "Re: FRI GYN: AIDS Prevention With Lime Juice?" Previous message: Rafael Haciski: "Re: Bisphosphonates and osteonecrosis - from an OMFS" My opinion is that there is no significantly increased risk of another ectopic in the same site. My understanding is that in most cases there is likely to be a permanent enlargement in the tubal diameter at that site - brought about by the enlarging pregnancy, and that there is no reason to be offering her a tubal ligation. A tubal ligation, in itself, if it fails, brings in another potential cause of a further ectopic. Steve ________________________________ From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Julio -- ________________________________ Arellano Sent: Monday, 5 June 2006 1:55 PM To: Multiple recipients of list OB-GYN-L Subject: Re: Ectopics - New case Dear Listmates: Forgive me if I wasn't clear enough but, as I wrote previously, it was an interstitial pregnancy, so, it could be hardly be worked out performing a linear salpingostomy, because of the vascularity of the cornual area. We decide to employ methotrexate therapy (which we don't use routinely) to offer her a less aggressive option to the uterine scar of a cornual resection (or even worst, the risk of an hysterectomy because of the bleeding), always keeping in mind her reproductive potential. In other words, we were taking care of her uterus in first place; to preserve the fallopian tube was a secondary outcome. So let me ask you the question in a different way (because I'm really not sure): what do you think is worst for her future fertility, the risk of a recurrent interstitial pregnancy in the same site, or the handicap subsequent to an unilateral tubal ligation (which, please tell me if am I wrong, doesn't mean sterilization) Thanks for your attention Dr. Julio C. Arellano Ob. & Gyn. La Plata. Buenos Aires Argentina arellano@netverk.com.ar -------Mensaje original------- De: Laure <mailto:lfolgar@vianwe.com> Fecha: 06/04/06 08:07:25 Para: Multiple recipients of list OB-GYN-L <mailto:ob-gyn-l@dns.obgyn.net> Asunto: RE: Ectopics - New case -----Mensaje original----- De: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net">mailto:ob-gyn-l@obgyn.net">ob-gyn-l@obgyn.ne t [mailto:ob-gyn-l@obgyn.net] En nombre de Dr Eberhard Lisse Enviado el: domingo, 04 de junio de 2006 10:33 Para: Multiple recipients of list OB-GYN-L Asunto: Re: Ectopics - New case Laure, on 6/4/06 10:13 AM Laure said the following: > - How high is the risk of a new implantation in the same site? In > other words: Who cares? > -The same as a salpingostomy. As above. > > - Is it high enough to consider an option to perform a laparoscopic > tubal ligation on this tube? Only if she wants to be sterilzed. > No, If you need to do this, Why we do salpingostomy and no > salpingectomy everytime?. To try and preserve fertility. Of course, what I try to say is if someone consider to do a tubal ligation after a conservative technics (metrotrexate) to avoid ectopic risk and this risk is the same of salpingostomy, logicaly, it is supossed that we need to do a tubal ligation in all salpingostomy (loosing the preservation of the fertility). The end of this is obviuos, no tubal ligation is needed to avoid risk of ectopic in this tube. About the risk of rupture, you are completly right. Patients and doctors who know how to do is all you need. L. Folgar OBGYN County Hospital Melilla Spain <http://www.incredimail.com/index.asp?id=410&lang=10> Next message: Gail Graham: "Re: FRI GYN: AIDS Prevention With Lime Juice?" Previous message: Rafael Haciski: "Re: Bisphosphonates and osteonecrosis - from an OMFS"

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