Any thoughts?

From: Malcolm Griffiths (Malcolm@MGRIFF22.demon.co.uk)
Wed Dec 2 14:28:09 1998


Saw a pateint a few weks ago for possible termination of pregnancy. She and her husband obviously had some doubts about the idea and had actually been considering sterilisation. She had some symptoms which suggested non-viable pregnancy, so I sent her for US.

US showed non-viable cornual pregnancy with biometry (just) <than dates.

I discussed surgical treatment with her but effectively suggested that we should follow conservative management with serial beta hCG. Levels slowly fell from 42,000 (!) to non-pregnat values, but US showed no shrinkage in ectopic.

I am due to review her in a few weeks.

She has two children and probably doesn't want any more.

She is perfectly well and assymptomatic now.

---
Would anyone disagree with conservative management? If so why? What
would you do?
---
Suppose she changes her mind and wants to try for a baby - any change in
management? (I have heard suggestion of such cases spont rupturing early
in next preg).
---
How would you manage the next pregnanacy (assuming it's IU)?
Malcolm Griffiths               MD,MRCOG,MFFP,Cert.Mgmnt
Obstetrician & Gynaecologist    Luton & Dunstable Hosp.,UK.
Tel:    01582-497459 (office)   Fax:    01582-497376
        01525-222849 (home)     email:  Malcolm@mgriff22.demon.co.uk
http://www.obgyn.net/board/griffith.htm
"CLINICAL FREEDOM IS THE LAST REFUGE OF THE CLINICALLY INCOMPETENT!"
(Someone [1997])




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