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Slow b-HCG titre riseFrom: Gordon M. Goldman (goldmang@medicine.wustl.edu)Mon Oct 30 19:31:49 1995
31 y/o WMF G1P0 w/LMP 08/27/95 seen on 10/11/95 w/hx spotting past two days. Exam showed uterus 5-6 wk.max and R tender adnexal mass of 4cm. Serial b-HCG 48 hrs. apart went only from 28M to 36M. U/S on 10/17 shows IUP and 4X3cm. R ovary, no free fluid, and ?small anterior fibroid in fundus. FHM, yolk sac and CRL compatible w/6wk,6days. Bleeding resolved but repeat exam showed persistent 4cm. mass and rpt. b-HCG again 48hrs apart on 10/18 & 10/20 were only 48M and 56M respectively. Exam 10/23 shows uterus at 7wk. Exam on 10/27 shows uterus at 7-8wk with normal R ovary. Rpt. b-HCG on 10/27 100M and U/S shows IUP good FHM,yolk sac and CRL@8wk,2d. Question: Any concern re:the slow rise of b-HCG now that the pregnancy seems established? Could genetic problems cause this? Would amnio be in order for genetic study, presuming the pregnancy continues uneventfully from here on (sp. ab. still a concern). Thanks,
-- Gordon M. Goldman, M.D.
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