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Re: Interesting pregnancy case =?iso-8859-1?b?lg==?= suggestions? From: Garry E. Siegel, M.D. (garrys@mindspring.com) Wed May 16 18:51:46 2007 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Richard Chudacoff, MD: "Re: Revised standard addresses timeframes for histories and physicals" Previous message: Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C.: "Re: Interesting pregnancy case =?iso-8859-1?b?lg==?= suggestions?" In reply to: Dean Huffman .: "Interesting pregnancy case =?iso-8859-1?b?lg==?= suggestions?" Next in thread: art fougner, md: "Re: Interesting pregnancy case =?iso-8859-1?b?lg==?= suggestions?" This is odd. Are you considering curettage? Does she conceive easily/want a third child? Could an MFM do a CVS and get chromosomes? Do you want somebody being invasive in a suspected mole? Those questions may help decide how to proceed. Garry At Wed, 16 May 2007, Dean Huffman . wrote: > >.. > >Interesting pregnancy case – suggestions? > >34 Y/O white female, G3 P2002 (uncomplicated vaginal deliveries), currently 11 >0/7 weeks gestation today. > >HCG at 7 6/7 weeks (for diagnosis of pregnancy) is 46,668. > >Ultrasound at 10 0/7 weeks of gestation showed normal fetus in gestational sac, >normal fetal heart beat, normal yolk sac present. An additional sac was >present, smaller that the first, appearance consistent with a gestational sac, >with apparent yolk sac (twice a large as the other one). Small amount of tissue >seen in the sac, size of 6 week gestation, no cardiac activity. HCG 104,865. TSH >normal. Right ovarian simple cyst 5 x 5 x 6 cm. > >10 2/7 weeks, HCG 117,178 (different laboratory). > >11 0/7 weeks. Fetus has appropriate growth, normal heart beat, appears normal. >Multiple cystic structures now seen in uterus, but outside gestational sac for >normal appearing fetus, measuring variously 0.5 – 2.7 cm. in diameter. Right >ovarian simple cyst 4.8 x 3.5 x 2.4 cm. Repeat quantative HCG pending. > >There has been nothing on ultrasound that shows a classic appearance of a >hydatidiform mole (multiple small cysts, “snow storm” pattern, etc.). > >I will see her in two days, along with gyn oncologist. > >Any thoughts or suggested diagnosis? Do you think this is a molar pregnancy? If >so, why so, if not, why not? Do you have any additional suggested laboratory >tests? Any suggested interventions? Any additional thoughts? -- Garry E. Siegel, M.D. Private Practice Roswell, GA Next message: Richard Chudacoff, MD: "Re: Revised standard addresses timeframes for histories and physicals" Previous message: Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C.: "Re: Interesting pregnancy case =?iso-8859-1?b?lg==?= suggestions?" In reply to: Dean Huffman .: "Interesting pregnancy case =?iso-8859-1?b?lg==?= suggestions?" Next in thread: art fougner, md: "Re: Interesting pregnancy case =?iso-8859-1?b?lg==?= suggestions?"

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