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Re: Ectopic for the 4th timeFrom: ATFSOCCER@aol.comFri Oct 3 20:00:50 1997
In a message dated 97-10-03 10:24:24 EDT, you write: << It would depend on the pain, her size, and other "Feel" factors. I have actually been unable to visualize a 7 week gestation by TVS in an obese patient. It doesn't sound like she is about to rupture (knock wood) also unless it is in the isthmic area right next to the uterus it shouldn't be big enough to rupture yet and your HCG's are going up like a normal pregnancy. Yes I know ectopics can also go up normally, but frequently they begin to fall off before they rupture. This is one of those "art" situations where you act a lot by feel rather than by an algorithm. This is why computers cannot practice medicine. -- >> 20% of ectopics do have normally rising hcg levels. An HCG of 3000 in our lab is well above the "discriminatory" level of 1500 at which we would see an IUP on TVUS. What difference would her weight make?? She has an ectopic until proven otherwise. Andy
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