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Re: Ectopic for the 4th timeFrom: art fougner, md (evsono@pipeline.com)Thu Oct 2 17:54:01 1997
At Thu, 2 Oct 1997, Geffrey Klein wrote: > >As you may recall, I presented a patient who presented with a positive >pregnancy test who had a history of prior ectopic 3 times. > >Brief recap: >28 y/o G4P0A3 LMP 8/13 Prior ectopic 3 times. The first was on the >right and ruptured. Laparotomy and right salpingectomy was performed. >Subsequently had 2 unruptured left ectopics treated with laparoscopy. > >Here is the follow-up: > >9/18 HCG 152 Hct 41% Prog 6.7 >9/20 HCG 266 >9/22 HCG 425 >9/24 HCG 844 >9/26 HCG 1564. Hct 40% US showed no IUP, ectopic, or free fluid. No >symptoms. VSS. Pt wanted to continue to wait on intervention. >9/29 HCG 3180. TVUS in the office done by me showed no IUP, ectopic, or >free fluid. No symptoms. VSS. Pt offered therapy but wanted another >ultrasound per radiology the next AM. >9/30 No IUP, ectopic, or free fluid per radiology ultrasound. >Presented to clinic c/o spotting and LLQ pain. > >Let's take votes on what to do: > >a) Methotrexate >b) Surgery (if you choose b, please indicate approach and procedure..) >c) Nothing > >Thanks... > >-- >Geffrey H. Klein, MD >Department of Obstetrics and Gynecology >MacGregor Medical Association >Clear Lake OB Office >2200 Nasa Road One Suite 200 >Houston, Texas 77058 >713 741 2273 x2628 > methotrexate good luck art
-- art fougner, md SonoScan/Genetic Sciences forest hills, ny evsono@pipeline.com
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