WOMENS-HEALTH Messages for June, 2001: Re: Abdominal pain & brown spotting

Re: Abdominal pain & brown spotting - differing opinions

From: R. Daniel Braun, MD (anonymous@obgyn.net)
Thu, 21 Jun 2001 18:55:35 -0500 (CDT)

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In reply to: Jo: "Abdominal pain & brown spotting - differing opinions"

At Thu, 21 Jun 2001, Jo wrote: >
>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
>

D & C is not without complications either. They include infection and scarring. I don't know what your Doc is thinking, but he hasn't just blown you off. He is evaluating and trying to decide the best thing to do for you. Give him a chance and let him know that you are concerned because you got the difering opinions.

--
R. Daniel Braun, MD FACOG  FOG

This is for educational purposes only, and is not intended to be replacement or substitute for consultation and examination by an appropriate medical professional.  Due to time constraints, private e-mails cannot be answered.

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