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Abdominal pain & brown spotting - differing opinions

From: Jo (anonymous@obgyn.net)
Thu, 21 Jun 2001 14:26:13 -0500 (CDT)


What could cause severe, sudden abdominal/pelvic pain (some brown spotting ongoing)?

Background: D&C for missed miscarriage Feb'01. Pregnant again ~4 weeks later & 2nd natural miscarriage April'01 - low, falling HCG levels & bleeding (no ultrasound). Since then, some brown spotting, sometimes watery, sometimes with tiny light-brown clots. Plus sometimes red spotting after sex. Last normal period Nov'00 before first pregnancy. Also have two centimeter-sized cysts.

Tuesday had a sudden bout of very severe abdominal pain - low down like cramps, diffuse throughout pelvic area, sometimes getting sharper. Came on quickly - within 45min was so bad went to emergency room (was out of town). Gave me morphine for the pain, blood/urine tests (normal, just a slightly low red blood cell count), ultrasound. HCG <1. Said I had 3.5cm mass in cervical canal - retained products of conception from my miscarriage, and my cervix had black blood with white flecks (couldn't tell if puss or normal discharge). After 3hrs, pain suddenly stopped, & I flew home with orders to see my doctor asap for D&C.

Followed up with my ob/gyn yesterday (Wed). Quick pelvic exam (poked around inside & outside - didn't look at cervix) and said it was impossible that I had retained products of conception still, because HCG <1. Said I didn't need a D&C, and scheduled an ultrasound Friday plus blood work. Said probably am getting period & just had very bad menstrual cramps.

Last night, ad some pain again - much less severe than before. Took Advil, laid down & it passed in about 2-3 hours.

Now I'm very confused! Isn't my doctor being too laid-back about this? The emergency room staff were emphatic that I needed to get a D&C asap & that there was serious risk of infection/scarring. Help!

--
Jo





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