|
|
 |
 |
 |
|
|
|||
|
||||
|
||||
Re: pregnancy after molarFrom: Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C. (johnprov@sympatico.ca)Thu Mar 29 04:35:42 2007
At Thu, 29 Mar 2007, poongulali selvamuthu wrote: > >Dear All, > >This is regarding a patient of mine who had a molar >pregnancy and was terminated .She inspite of all >counseling has conceived again before HCG touched down >and is now in the 7th week normal pregnancy .Is there >a chance of chromosomal anomalies in this foetus ? >If so what is the percentage? > >Regards, >Poongulali.S > >____________________________________________________________________________________ >Don't get soaked. Take a quick peek at the forecast >____________________________________________________________________________________ > >-- >http://tools.search.yahoo.com/shortcuts/#loc_weather > The chances are about the same or only slightly higher than if she did not have a molar pregnancy; it sounds like she did not require chemtherapy even if she did have any chem(usually Methotrexate is long gone.) it is not the risk of chromosomal abnormalities that would concern me. The reason for not getting pregnant untill the B HCG is in the non-pregnant range for about a year is that BHCG is your marker for reccurence of the molar pregnancy and possible need for chemotherapy. There have been some recent papers mostly metaanlysis which have shown that you don't have to wait for one year after BHCG has returned to normal to concieve. In your patient you do not known whether she had been completly cured because her BHCG never got into the negative range. The nightmare scenario is that her BHCG did not go to Negative because she had early metastatic disease, if she had early metastatic disease then the new pregnancy will almost certainly make it worse and she will require agressive chemtherapy which will put the current pregnancy at extreme risk, indeed if she goes on to chem most Physicians would recommend termination. By not waiting for her BHCG to get into the negative range she has made the situation difficult and uncertain for eeveryone.
--
Take care, John
|
|
Return to
|
Mail a New Message to the Forum: ob-gyn-l@obgyn.net Forum Administrator: geffrey.klein@obgyn.net Report Technical Problems: webmaster@obgyn.net Last Updated: Fri May 2 04:47:14 2008 |
The American Medical Association is no longer designating CME hours for AMA Category II CME credit. However, physicians themselves may self designate learning activities as Category II CME credit hours if they feel it is of sufficient educational merit and meets the formal definitions of continuing medical education. OBGYN.net believes these interaction in this forum meets these criteria. For further information see the AMA web site.