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Re: OB: after the accreta? From: Bernard Cristalli (bcrist@club-internet.fr) Fri Aug 21 15:24:41 1998 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Terrence.Jones@ncal.kaiperm.org: "Re: OB: after the accreta?" Previous message: Richard M. Chudacoff, MD: "Re: OB: after the accreta?" Maybe in reply to: Geffrey Klein: "OB: after the accreta?" Next in thread: Terrence.Jones@ncal.kaiperm.org: "Re: OB: after the accreta?" Geffrey Klein wrote: > > Hi all.. suggestions please. > > 33 y/o G4P3A1 who had 2 cesarean sections and a tubal ligation conceived with IVF and > developed a placenta previa. After mature lung profile obtained, cesarean section > performed in 5/98 and per the operative report the placenta was easily and completely > removed. However, pt returned 6/98 with hemorrhage that responded to D&C. > The pathology specimen commented on placental villi in the specimen. Pt is now on ocps > and states that every day she bleeds like a light day of a cycle. When she is in the placebo > week of her pills, she experiences heavy bleeding with clots. Pt came to see me today for > an opinion. On exam, pt does not appear pale (hgb ordered). Pelvic reveals some bleeding, > but not profuse. The uterus feels non-gravid on bimanual exam. > > Treatment options? > A) continued observation, ocps and Fe > B) repeat D&C > C) Hysteroscopy > D) Endometrial ablation > E) Hysterectomy > -- C +/- D if she still wants a pregnancy E if not -- Bernard Cristalli MD CNGOF AIHP - ACCA Paris - France http://www.obgyn.net/corresp/cristalli.htm http://www.cliniquedelessonne.fr/ Next message: Terrence.Jones@ncal.kaiperm.org: "Re: OB: after the accreta?" Previous message: Richard M. Chudacoff, MD: "Re: OB: after the accreta?" Maybe in reply to: Geffrey Klein: "OB: after the accreta?" Next in thread: Terrence.Jones@ncal.kaiperm.org: "Re: OB: after the accreta?"

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