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Re: after the accreta? From: Braun, R. Daniel (rbraun@iupui.edu) Sat Aug 22 07:03:50 1998 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Philip Rosenow: "Re: VBAC literature" Previous message: Bulent Potur: "Re: after the accreta?" What is her Urine preg. Test?? Does she have some retained living placenta? Does she have GTD?? I think I would want to review the slides from the D&C to make sure there wasn't any abnormal villi. If none and her UPT is negative, I would opt for Plan "A". Have I ever mentioned Braun's Law of the Vaginal Bleeder to the List ?? -- Braun's Law: "The heavier the bleeding, the higher the hemoglobin." Dan -----Original Message----- From: Geffrey Klein [SMTP:GK6972@americanmed.com] Sent: Friday, August 21, 1998 1:41 PM To: Multiple recipients of list Subject: 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: Philip Rosenow: "Re: VBAC literature" Previous message: Bulent Potur: "Re: after the accreta?"

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