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Re: Abnormal Pregnancies (HCGs/Progesterones)From: Bryan S. Jick, M.D., F.A.C.O.G. (drbryan@earthlink.net)Sat Oct 11 23:42:14 1997
At 03:40 PM 10/11/97 -0500, you wrote: I've done the same thing. Agree with you. Hardest part is explaining all this to the patient.
>I am interested in how the listmembers handle cases such as this: (From
>memory, so my numbers are close, but the concept is the same)
>
>30 YO Para 0010 ( a "chemical pregnancy" per the patient) on clomid 150
>mg. for oligoovulation, who has a PCO type hormone picture, has a
>positive pregnancy test at home, and her HCG is initially 144, then 2
>days late is 150 or so, with an initial Progesterone of less than 5.
>Over the weekend, she is spotting a bit, clinically normal, with normal
>exam. The next HCG a couple of days later was around 250.
>
>I did not do an ultrasound, believing that it would not alter my
>management below.
>
>My diagnosis was an abnormal pregnancy, and I gave her methotrexate 50
>mg. per meter squared. She had normal liver tests and a normal CBC
>beforehand, and her HCG on initiation was 380 or so, and 5 days later it
>is 220 or so. I'm going to follow it weekly down to zero hopefully.
>
>I realize that I did not prove an ectopic by ultrasound or by
>endometrial curettage; however, clearly she has an abnormal pregnancy,
>and, IMHO, this has saved her an OR trip hopefully.
>
>What do ya'll think?
>
>--
>Garry E. Siegel, M.D., FACOG
>Private Practice
>Roswell, Ga.
>
> <color><param>0000,0000,ffff</param><bigger>Bryan S. Jick, M.D., F.A.C.O.G. Pasadena, California drbryan@earthlink.net</bigger></color>
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