WOMENS-HEALTH Messages for May, 1997: Re: Thank You, Dr. Ashley Hill!

Re: Thank You, Dr. Ashley Hill!

From: Kelly (anonymous@obgyn.net)
Wed, 28 May 1997 23:50:48 -0500 (CDT)

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At Wed, 28 May 1997, D. Ashley Hill, M.D. wrote: I don't routinely send 1st trimester >miscarriage material for genetic analysis (after all, why pay hundreds
>of dollars to tell me there's a chromosomal problem when that's
>*exactly* the number 1 cause of 1st trimester losses)! However, all such
>"products of conception" should be examined to make sure there's no
>other abnormalities, such as a "molar pregnancy." So, I would suspect it
>could be collected in a sealed container, and placed in the refrigerator
>until the next morning, but since I'm unsure, I'll try to talk with
>someone in the pathology department tomorrow (in-between surgeries).
>
>If anybody else knows, please jump in and give me a hand!
>
>Thanks,
>
>Ashley

Ashley

What a wonderful article you wrote on miscarriage; as a fellow physician and a woman who has had 2 miscarriages, I can unequivocally state that it was one of the most medically correct, unbiased and sensitive pieces I have read on the subject.

I'd like to emphasize a couple of points you made, given the unfortunate wisdom of experience that I possess on this subject. The decision to have - or not have - a D&C is very individual, as you said. I've gone both routes and each has its own advantages and disadvantages. Some factors in the equation are how far along (the farther along, the more tissue to be passed and the greater the potential for bleeding with letting nature take her course), the availability of medical care should heavy bleeding start, the need or desire to obtain tissue for genetic studies and the all important psychologic issues.

You were so on target with your advice on how to respond to news of a miscarriage. The simple words "I am sorry for your loss" mean more than the speaker can ever imagine; by those few words, you are acknowledging that this is indeed a loss to the couple, that you care and that you support them. The grief process can last a long time, and every anniversary of the due date may bring fresh pain (May 31 and December 9 will be difficult days for me). Someone who has not experienced a miscarriage may not be able to understand that; understanding is not a prerequisite for caring.

Re: saving the products of conception (the pregnancy tissue), just put it in a clean container in the fridge until it can be taken to the doctor -- plastic baggies work very well. Even if it is someone's first first trimester miscarriage, under some circumstances genetic studies may be warranted.

Thanks again for your article Ashley. You are quite an asset to our field and to this list.

Kelly

-- Kelly Shanahan, MD, FACOG S. Lake Tahoe, CA

note: Opinions here are for educational purposes only. This information is not intended to supplant the need for you to consult with your own physician. It cannot take the place of a face to face consultation and examination.

Next message: Linda: "HRT progesterone dosage"
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