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Re: after the accreta? From: Bulent Potur (bpotur@superonline.com) Sat Aug 22 06:39:38 1998 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Braun, R. Daniel: "Re: after the accreta?" Previous message: Hans van der Slikke, OBGYN: "Re: Clamping cord time." First I would examine the uterus and adnexa with ultrasound, if no major intrauterine collection or adnexal cyst (unruptured follicle) I would opt for continued observation with endometritis treatment. In the mean time I would obtain serial bHCG determinations. If positive constantly or rising I woud consider Mtx treatment. And I also would keep in mind the possibility of mid cycle bleedings with low dose OCP's. I had a similarly bleeding patient past 2 months after C/S who responded nicely to conservative treatment and follow-up. Regards. Bulent Potur, M.D. Obgyn. Cumhuriyet Meydani Dumerler Ishani Kat 2 71100 Kirikkale Turkey (90) (318) 224 53 10 bpotur@superonline.com http://abone.superonline.com/~bpotur/ -----Özgün İleti----- Kimden: Geffrey Klein <GK6972@americanmed.com> Kime: Multiple recipients of list <ob-gyn-l@talk.obgyn.net> Tarih: 21 Ağustos 1998 Cuma 20:42 Konu: OB: after the accreta? >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 > >Anyone with experience with this? > >Geffrey H Klein, MD >Dept OB-GYN >MacGregor Medical Association >2200 Nasa Road 1 Suite 200 >Houston, Texas 77058 >(713) 741-2273 ext. 2628 >geffrey.klein@obgyn.net Next message: Braun, R. Daniel: "Re: after the accreta?" Previous message: Hans van der Slikke, OBGYN: "Re: Clamping cord time."

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