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Re: Abnormal Pregnancies (HCGs/Progesterones) From: R.Daniel Braun, MD FACOG (rbraun@netdirect.net) Sun Oct 12 13:47:15 1997 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: R.Daniel Braun, MD FACOG: "Re: Face presentation & No Forceps" Previous message: R.Daniel Braun, MD FACOG: "Re: Abnormal Pregnancies (HCGs/Progesterones)" In reply to: John Schmitt: "Re: OB-GYN-L digest 1275" Next in thread: Geffrey Klein: "Re: Another Multiple Prior Ectopic Patient" At Sun, 12 Oct 1997, Bernard Cristalli wrote: > >Garry E. Siegel, M.D. wrote: >> >> 30 YO Para 0010 ( a "chemical pregnancy" per the patient) on clomid 150 >> mg. her HCG is initially 144, then 2 days late is 150 or so, >> >> 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. >> and her HCG on initiation was 380 or so, and 5 days later it >> is 220 or so. . >> >> 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? >> >-- >Ok for the abnormal pregnancy. >I would have tried to prove an ectopic at least with an US. For future >pregnancies prognosis. What about the medico-legal side of the case? >just a question. > >-- >Bernard Cristalli MD CNGOF >AIHP - ACCA >Paris - France >http://www.obgyn.net/corresp/cristalli.htm > In this case an ultrasound would be a waste of time and money. If you are convinced it is an abnormal preg., MTX is the way to go. If not see my last post. -- R.Daniel Braun, MD "Heisenberg might have slept here" Unknown or Indecisve Next message: R.Daniel Braun, MD FACOG: "Re: Face presentation & No Forceps" Previous message: R.Daniel Braun, MD FACOG: "Re: Abnormal Pregnancies (HCGs/Progesterones)" In reply to: John Schmitt: "Re: OB-GYN-L digest 1275" Next in thread: Geffrey Klein: "Re: Another Multiple Prior Ectopic Patient"

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