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Re: positive pregnancy test ??From: ATFSOCCER (ATFSOCCER@aol.com)Sat Dec 13 13:14:56 1997
In a message dated 97-12-13 07:59:26 EST, you write: << clinical findings: she started with a continues dark blood spotting since 3 weeks ago with no clots and no pain at all , until now. The first vaginal US Dec 8 97: showed a large occupied uterus with a mixed shadow ( a sac ??) 6 x 5 x 5 cms no gestacional sac, no vitelin sac neither, no embryo. There is a left adnexal cyst, 5 x 5 x 5 cms Mixed also ( corpus luteum ??), and the rest of the vaginal US findings are negative for an ectopic pregnancy so far. Mild pain with bi-manual exploration. Today Dec 11 97 the US findings are the same and the sub Chorionic B unit is 62,000 IU. No acute syntoms. Just the dark blood spotting. Our diagnostic possibilities are: alive (active) ectopic pregnancy (some where), trophoblastic disease or uncompleted abortion. Treatment.- an other quantitative pregnancy blood test and wait Laparoscopy and D and C Or just D and C. Any opinion, any other suggestion Thanks Manuel R. Garcia MD. >> Dear Manuel I would think with the slow rising HCG's and no evidence of intrauterine pregnancy that you have an estremely high probability of a tubal ectopic pregnancy. I would vote for the diagnostic laparoscopy with probable salpingostomy or salpingectomy. ASAP. HCG too high and adnexal mass too big for successful use of methotrexate. Keep us posted, Andrew Folley MD FACOG Toledo
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