WOMENS-HEALTH Messages for July, 2007: Re: PREGNANCY: Cesarean ectopic (Update)

Re: PREGNANCY: Cesarean ectopic (Update)

From: William F. von Almen, II, MD, FACOG (anonymous@obgyn.net)
Mon, 30 Jul 2007 22:20:00 -0500 (CDT)

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In reply to: Karen: "Re: PREGNANCY: Cesarean ectopic (Update)"

Karen

I had a pt once that had a retained placental polyp after a spontaneous miscarriage with no D+C. She could not get pregnant until we removed the polyp via hysteroscopy. I wish you luck...Dr. von Almen

At Mon, 30 Jul 2007, Karen wrote: >
>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.
>>

--
William F. von Almen, II, MD, FACOG
Private Practice
New Orleans, La.

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In reply to: Karen: "Re: PREGNANCY: Cesarean ectopic (Update)"

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