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Re: Invasive mole-quiz From: Bernard Cristalli (bcrist@club-internet.fr) Sun Aug 17 13:46:26 1997 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Bernard Cristalli: "Re: "Novus T" (??) I.U.D." Previous message: Bernard Cristalli: "Re: Stopping periods" Maybe in reply to: Malcolm Griffiths: "Invasive mole-quiz" Next in thread: Malcolm Griffiths: "Re: Invasive mole-quiz" Reply: Malcolm Griffiths: "Re: Invasive mole-quiz" Malcolm Griffiths wrote: > > Dealt with an intersting case this last week, whilst my PC was out of > action. > > 21yo in first pregnancy attends our early pregnancy clinic (EPC) with > bleeding late in first trimester. US shows disorganised sac and mixed > echoes thought to indicate incomplete/missed abortion. She was advised > to have an evacuation but disappeared before we had finished with her. > ... > > Cavity was evacuated transcervically with direct visualisation of uterus > transabdominal to prevent further iatrogenic perforation. > > Ruptures were oversewn but bleeding continued. Bilat iliac artery > ligation gave haemostasis. A drain was left in situ. This was all done > by a colleague on Thursdaynight/Friday am (7th/8th). On 8th he went on > holiday ! > > I was on-call then. Sunday afternoon she had a post-op ileus and fresh > bleeding from her drain. About 300ml in total. > > What interventions did I consider ? TAH if sutures were not efficient > > I then managed to contact Prof Newlands team at Charing Cross Hospital > in London. Used to be Prof Bagshaw's unit. > What did they say ? It looks like a placental site trophoblastic tumour Locally invasive, uterine perforation... > > What was her betaHCG when we finally got one done ( bear in mind this > was <3 weeks after it was 900 ) ? Negative > > Would anyone do anything different ? I don't know you didn't say what you did ;-) -- Bernard Cristalli MD CNGOF AIHP - ACCA Paris - France http://www.obgyn.net/corresp/cristalli.htm Next message: Bernard Cristalli: "Re: "Novus T" (??) I.U.D." Previous message: Bernard Cristalli: "Re: Stopping periods" Maybe in reply to: Malcolm Griffiths: "Invasive mole-quiz" Next in thread: Malcolm Griffiths: "Re: Invasive mole-quiz" Reply: Malcolm Griffiths: "Re: Invasive mole-quiz"

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