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Re: ? ectopic pregnancyFrom: Martin Necas and Tania Keep (exiled@clear.net.nz)Sun Mar 14 21:01:44 1999
Dear Juan, It appears to me that your clinical suspicion of ectopic pregnancy does not warrant immediate intervention. In this case, your other option is to wait until the bHCG is >1000-1500 and repeat the transvaginal ultrasound. You should be able to identify a gestational sac in the uterus if this is an early intra-uterine pregnancy. If there is no evidence of IUP, look for adnexal mass, or free fluid as signs indicating an ectopic pregnancy. Unfortunately, ultrasound can be prone to diagnostic errors. Not too long ago we had a patient with acute RLQ pain, slight bleeding, bHCG around 700, no identifiable IUP, adnexal mass, and free fluid with debris (hemorrhage). The patient was rushed to theatre where laparoscopy revealed a hemorrhagic corpus luteum, but no ectopic pregnancy. Yours, Martin Necas, RDMS, RVT Sonographer Waikato Hospital, Hamilton, NZ -----Original Message----- From: ultrasound@obgyn.net [mailto:ultrasound@obgyn.net] On Behalf Of Juan Carlos Otero Sent: Monday, March 15, 1999 10:04 AM To: Multiple recipients of list Subject: Dear friends I have a case : It is a woman 29 years old, who has 6.2 weeks . She went to the hospital for pain . Her vaginal ultrasound scaner has not sac in utero or out side. Her firts sub beta gonadotopin was 435 we take other 48 hours late and is 819, we where thinking at the firts time in probabli ectopic precnancy but with the gonadotopin incresing to doble maybe could be early pregnancy . What do you thing?. her hemoglobin is 13 and she has not pain now.
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