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Re: Ob: Cornual EctopicFrom: rmodugno@aol.comTue Aug 26 20:06:27 2008
LAVH Robert Modugno MD MBA FACOG Sylva, NC -----Original Message----- From: Garry E. Siegel, M.D. <garrys@mindspring.com> To: Multiple recipients of list OB-GYN-L <ob-gyn-l@mail.obgyn.net> Sent: Tue, 26 Aug 2008 6:09 pm Subject: Ob: Cornual Ectopic 43 YO P2022, relatively new patient to the practice, seen by partners but due to vacation, office rotation, comes to my attention. She and her husband seem reasonable and quite intelligent. 2 term SVDs, children 3 and 6, both severly autistic (her words), and two spontaneous first trimester losses. HCG yesterday 17K, and ultrasound today with MFM is suggestive if not diagnostic of a cornual pregnancy. She has had a laparotomy for a unilateral S and O at age 16 ("large cyst") and a subsequent laparoscopy years ago for adhesions. Methotrexate offered and declined due to toxic chemicals, long term effects, etc. Clearly, the two autistic children weigh into decision making in terms of exposure to "stuff." Her exam is benign, 8 week size non-tender uterus. She is thin and has a low transverse skin incision. She requests hysterectomy. What say you? If you do it, how? Garry
-- Garry E. Siegel, M.D. Private Practice Roswell, GA
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