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Re: PREGNANCY: Cesarean ectopic (Update)
From: Karen (anonymous@obgyn.net)
Mon, 30 Jul 2007 10:22:09 -0500 (CDT)
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Update:
I had a hysteroscopy that allowed us to see the retained tissue up
close. (Very cool, by the way.) At this time, my doctor has recommended
a wait and see approach. We will wait three months and allow the tissue
to break down on its own. In three months, another ultrasound will be
performed to determine if the tissue is still present. Assuming it is
completely resolved, I will then have a HSG to try to determine uterine
integrity (for possible future pregnancy(ies).)
At Thu, 26 Jul 2007, William F. von Almen, II, MD, FACOG wrote:
>
>Karen
>
>I have never had a case such as this, so I have no clue. Please let us
>know what your doctor suggests...Dr. von Almen
>
>At Thu, 26 Jul 2007, Karen wrote:
>>
>>I posted a few days ago asking questions about my future fertility, but
>>my situation has since changed, as has my question.
>>
>>An ultrasound yesterday revealed that despite undetectable hCG levels, I
>>am still retained placenta increta in my cesarean section scar, 2.1 x
>>2.1 x 1.5 cm. There is vascular flow to this area, but it has not grown
>>(or shrunk) since my last ultrasound on 6/18/07.
>>
>>The doctor performing the ultrasound told me that methotrexate is not an
>>option, because it works on dividing cells, and this mass is not
>>dividing. (I had methotrexate when the ectopic was first diagnosed, and
>>that did eliminate the viable tissue, bringing my hCG down to
>>undetectable levels.) She said she wasn't sure what my doctor would
>>recommend. I have an appointment scheduled to discuss with my doctor.
>>
>>In the meantime, can I assume that surgical removal of the tissue is
>>likely to be the recommended treatment? What kind of surgery? Can you
>>recommend questions I should ask of my doctor?
>>
>>Thank you in advance for your input.
>
>--
>William F. von Almen, II, MD, FACOG
>Private Practice
>New Orleans, La.
>
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