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Re: Failed tubal ligations From: Joanne Bulley, MD (islesannie@gmail.com) Fri Feb 9 06:45:21 2007 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Elrod, Darryl G Maj 48 MDOS/SGOBO: "Re: Failed tubal ligations" Previous message: art fougner, md: "Re: Failed tubal ligations" In reply to: Elrod, Darryl G Maj 48 MDOS/SGOBO: "Failed tubal ligations" Next in thread: Andrew Folley: "Re: Failed tubal ligations" We had one patient in my old practice that had her TL at C/S - with pathology confirming that there were indeed 2 segements of tubes sent to them. She had an intrauterine pregnancy - carried to term and had a repeat C/S. The TL LOOKED PERFECT!!! There was no possible way to figure how that fertilized egg / blastocyst ever made itws way to the uterus. She chose not to have a TL revision. I think her husband had a vas. In this patient - I would agree that is was ectopic by the quants and offer MTX. As far as future fertility - why not a Mirena? The efficacy is better than a TL. Or an Essure. Now I will read the others suggestions. I am probably suggesting something that others have! Joanne At Fri, 9 Feb 2007, Elrod, Darryl G Maj 48 MDOS/SGOBO wrote: > >I have a gal that I did a c-section tubal on 8 months ago (with path >specimens showing tubal segments) that now has a positive home pregnancy >test. > >Repeat quants have been 191, 282, and 390 at 48 hr intervals. Pt is >without symptoms. > >My presumption is that this is an ectopic based on the history and the >abnormally rising quants. > >My plan would be to give her methotrexate now to treat the ectopic. > >When you any of you consider doing l/s to repeat the tubal? Now? 6 >weeks? > >Thanks, > >Glen > >//SIGNED// > >D. Glen Elrod, Maj., USAF, MC > >Obstetrician/Gynecologist > >Chief of Obstetrics > >48 MDOS/SGOBO > >RAF Lakenheath, England > >Telephone DSN: 314-226-8130 > > Comm: +44 (0) 1638 52 8130 > >Notice of Confidentiality >Under the Privacy Act of 1974, you must safeguard all information >reflected on this e-mail and, if applicable, all attachments. >Disclosure of information is IAW AFI 33-119, AFI 33-127, AFI 37-131, AFI >37-132, AFI 33-219, and PL 93-579" >This e-mail message including any attachments is for the sole use of the >intended recipient(s) and may contain confidential and privileged >information. Any unauthorized review, use, disclosure or distribution is >prohibited. If you are not the intended recipient, please contact the >sender by reply e-mail and destroy all copies of the original message. >Any questions pertaining to disclosure should be directed to the privacy >officer. -- Joanne Bulley, MD, FACOG Solo gyn Keene, NH USA Next message: Elrod, Darryl G Maj 48 MDOS/SGOBO: "Re: Failed tubal ligations" Previous message: art fougner, md: "Re: Failed tubal ligations" In reply to: Elrod, Darryl G Maj 48 MDOS/SGOBO: "Failed tubal ligations" Next in thread: Andrew Folley: "Re: Failed tubal ligations"

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