Grand Rounds 4.39 at Marianas Eye
Tuesday, June 17, 2008
Kenneth F. Trofatter, Jr., MD, PhD
Thanks to Dr. David Khorram at
Marianas Eye for hosting and all the effort put into this week's Grand Rounds 4.39. The variety, breadth, and presentation of the offerings (not to mention the great photos at the bottom of the page) make a quick trip to his "island in the South Pacific" a very worthwhile investment in time.
Special appreciation, too, for the link to my recent post on
"Asherman's Syndrome." As Dr. Khorram summarizes in the reference to my post, Asherman's syndrome is a condition related to scarring of the intrauterine cavity, usually as the result of a failed pregnancy and a D&C in the presence of infection, or another intrauterine surgical procedure, that can result in light (hypomenorrhea) or absent menstrual periods (amenorrhea), infertility, and recurrent pregnancy loss as well as other pregnancy complications. It is more common than most women realize and should be discussed as part of informed consent counseling with any woman prior to any intrauterine procedure. In a subsequent post, we continue the discussion of Asherman's syndrome with regard to
diagnosis, treatment, and prevention. Thanks for reading and hope you enjoy!
Dr T
Labels: Asherman's syndrome
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6 Comments:
At Fri Jun 27, 03:30:00 PM 2008,
Shannon Howe said…
Hi Dr. Trofatter,
I actually just wanted to write to say hello. I was your challenging patient last year (sept-dec), and was on the high risk unit for that entire time. But it resulted in beautiful boy/girl twins born healthy at 36 weeks. Your amazing cerclages did the trick, and the OB who performed the c-section actually complained that the stitches were very difficult to get out! The babies are almost 6 months old and crawling everywhere. I appreciate all you did to keep me pregnant as long as I was. We will never forget you!
Shannon Howe and family
At Mon Jun 30, 11:20:00 AM 2008,
Anonymous said…
Dr. Trofatter,
I apologize for posting off topic. I have a question for you. I'm 26 weeks pregnant and went in to be checked due to discomfort low in my abdomen. All checked out OK and they told me the discomfort is from carrying the baby very low. She said that he's already head-down at -1 station, and she recommended a pregnancy girdle for relief. Does this positioning place me at any risk for preterm delivery?
Thank you!!!!!!!!
At Tue Jul 01, 06:47:00 PM 2008,
Kenneth F. Trofatter, Jr., MD, PhD said…
To Shannon: I will never forget you folks either! I cannot tell you how many more "rescue cerclages" I have placed in the past year - two recently with twins in the same situation as you wee in. I mention your success to these folks to give them some real hope. Give your babies and your husband big HUGS from me. Dr T
At Tue Jul 01, 06:50:00 PM 2008,
Kenneth F. Trofatter, Jr., MD, PhD said…
To anonymous June 30: Is the discomfort in your abdomen or is it over the middle of the pubic bone. Regardless, some women can carry a baby "low" and be at no increased risk for preterm birth and others really are at risk. Has your cervix been evaluated by ultrasound to see if it is short and/or "funneling?" Best of luck and I hope you carry to term! Dr T
At Wed Jul 02, 05:46:00 AM 2008,
Anonymous said…
Thank you for your reply! I would say that the discomfort is over the pubic bone more so than in the abdomen. They did do a cervix check by ultrasound a couple weeks ago and all was well. The measurement was over 4, but I don't remember the exact number. There was no funneling.
At Thu Jul 03, 07:18:00 PM 2008,
Kenneth F. Trofatter, Jr., MD, PhD said…
To anonymous July: If your pain is over the pubic bone and in the midline, you may be having some degree of separation of the pubic symphysis (the rubbery ligament that binds the pubic bones together in the midline). This can stretch under the influence of pregnancy hormones and the weight and position of the baby. It can be quite uncomfortable, but does not increase your risk for early delivery. The pregnancy support girdle might help you somewhat under these circumstances. Good luck! Dr T
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