Re: Interstitial pregnancy
From: art fougner, md (evsono@pipeline.com)
Wed Oct 8 18:20:48 2003
Dr. Moroder
sounds good to me. Well-done.
art
At Wed, 8 Oct 2003, Wolfgang Moroder, M.D. wrote:
>
>Thank you, we decided for laparotomy since the patient had a previous
>laparotomy in Serbia under unclear circumstances. We didn't regret it
>since the left angle of the uterus involved in the interstitial
>pregnancy was completely covered by the adherent colon.Wolfgang
>
>At Wed, 8 Oct 2003, art fougner, md wrote:
>>
>>Dr. Moroder
>>
>>very nice mpeg ... quite diagnostic IMHO. One question about the
>>surgery ... why not laparoscopic treatment?
>>
>>art
>>
>>At Tue, 7 Oct 2003, Wolfgang Moroder, M.D. wrote:
>>>
>>>The pictures and comments on the laparotomic treatment of the
>>>interstitial pregnancy are ready temporarely here for vision.
>>>This is the appearance at opening:
>>>
>>>http://apps.obgyn.net/ultrasound/photos_action.cfm?id=320
>>>
>>>this is the repair of the uterus
>>>
>>>http://apps.obgyn.net/ultrasound/photos_action.cfm?id=321
>>>
>>>Write me for any question
>>>Wolfgang
>>>
>>>At Mon, 6 Oct 2003, Wolfgang Moroder, M.D. wrote:
>>>>
>>>>To see the videoclip (1.6 Megabyte) download from here:
>>>>
>>>>ftp://ftp.obgyn.net/pub/ULTRASOUND/interstiziale.m1v
>>>>Wolfgang
>>>>
>>>>At Mon, 6 Oct 2003, Wolfgang Moroder, M.D. wrote:
>>>>>
>>>>>Dear Terry. The videoclip is 1.6 MB. At this time it should be arrived
>>>>>(one never knows, once an e-mail took 4 full days to go to my next
>>>>>town...). Dscription of the clip: in a transvaginal coronal plane,you
>>>>>can see on the lefthand side of the fundus a flourishing pregnancy with
>>>>>an embryo of 9 weeks. In the last pictures of the clip a thin
>>>>>hypoechogenic endomiomitrial layer is more easily seen. The gestational
>>>>>sac is very eccentric. In none of the scans a connection of the chorion
>>>>>to the endometrial-decidual layer could be demonstrated. Although
>>>>>described in literature (Ackerman, Radiology 1993,189/1/83), I cannot
>>>>>recognize the "interstitial line sign".
>>>>>The patient refused treatment with methotrexate and left the hospital
>>>>>saying that she was leaving for Serbia. She returned on Saturday night
>>>>>with pain in the left lower abdomen. On Sunday night the pain worsened
>>>>>and on Monday mornig we decided to do a laparotomy for symptoms of
>>>>>haemoparitoneum. The patient had a previous laparotomy with
>>>>>salpingectomy for a left tubal pregnancy. On opening we found a
>>>>>moderate haemoperitoneum. The fundus uteri was covered with colon
>>>>>firmly attached to it. During accurate preparation and involuntary
>>>>>pressure on the fundus a 2.5 cm long fetus jumped out of the field. The
>>>>>thin layer of myometrium ruptured. All the chorion was accurately
>>>>>removed and the chorionic bed cleaned. The uterine opening was finally
>>>>>repaired with a continous suture.
>>>>>Best regards
>>>>>Wolfgang.
>>>>>
>>>>>At Sun, 5 Oct 2003, Terry J DuBose wrote:
>>>>>>
>>>>>>Wolfgang, I just got back to town.... How large is your MPG videoclip?
>>>>>>Could you email it directly to my university email... I can accept up to
>>>>>>about 5 megabytes there. Otherwise I think that Bruce or Kevin will
>>>>>>have to open a FTP site for you if it is a large file. It can be done,
>>>>>>but as a last resort there are CD ROMs and snail-mail.
>>>>>>
>>>>>>Thanks for being here. What can you tell us about the video?
>>>>>>
>>>>>>Peace, Terry J DuBose, M.S., RDMS
>>>>>>Little Rock, Arkansas USA
>>>>>>
>>>>>>On Sun, 5 Oct 2003 11:48:54 -0500 wolfgang.moroder@tin.it (Wolfgang
>>>>>>Moroder, MD) writes:
>>>>>>> To my experience (I am practicing OB-GYN in a major hospital since
>>>>>>> 30
>>>>>>> years) interstitial pregnancy is not as common as described in
>>>>>>> literature: 2-4% of all ectopic pregnancies. I'd like to submit a
>>>>>>> case
>>>>>>> in form of a short videoclip of a suspected interstitial pregnancy
>>>>>>> at 9
>>>>>>> weeks in order to collect some comments from the audience of this
>>>>>>> forum.
>>>>>>> Please let me know how I can post the clip which is in a MPG
>>>>>>> format.
>>>>>>> Best regards Wolfgang
>>>>>>>
>>>>>>> --
>>>>>>> Wolfgang Moroder, MD
>>>>>>> Prenatal Unit
>>>>>>> Bolzano General Hospital Italy
>>>>>>>
>>>>>--
>>>>>Wolfgang Moroder, MD
>>>>>Prenatal Unit
>>>>>Bolzano General Hospital Italy
>>>>>
>>>>--
>>>>Wolfgang Moroder, MD
>>>>Prenatal Unit
>>>>Bolzano General Hospital Italy
>>>>
>>>--
>>>Wolfgang Moroder, MD
>>>Prenatal Unit
>>>Bolzano General Hospital Italy
>>>
>>--
>>art fougner, md
>>ich bin ein New Yorker
>>
>--
>Wolfgang Moroder, MD
>Prenatal Unit
>Bolzano General Hospital Italy
>
--
art fougner, md
ich bin ein New Yorker
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