Re: ULTRASOUND digest 31
From: Art Fougner MD (evsono@pop.pipeline.com)
Mon Dec 22 22:38:47 1997
don't know if this helps but the literature suggests ( can't locate the
reference at present ) that the discriminatory zone for observing fetal
cardiac activity is 30,000 IU. however, medicine is like life - few always
and fewer nevers. had one case where HCG was 31,000 and no iup was seen. pt
was scanned 3 days later ( was asymptomatic and s/p IVF). at that time 3 IUG
sacs were identified. all 3 kids have finished 1st grade now. :)
merry Xmas to all
art
--
art fougner md
forest hills ny
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>Date: Fri, 19 Dec 1997 21:30:09 -0500
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>From: JT or JL Tomko <buddy@redrose.net>
>To: ultrasound@obgyn.net
>Cc: lawson98@juno.com, ultrasound@talk.obgyn.net
>Subject: Re: ULTRASOUND digest 31
>Message-ID: <1.5.4.32.19971220023009.006c7c4c@redrose.net>
>
>Mark,
>Not sure I understand your post but thanks for the dearheart. 7-8 k? Not
>sure if you mean 7000 IU BHCG or 7-8 week. I use the level amounts when the
>image and history doesn't fit. I would not have called yours an ectopic
>without a follow up if patient was asymptomatic especially not seeing
>cardiac before at least a 10,000 IU level. Could you clarify as I am always
>interested in those that just don't fit the program.
>I will also always watch how the levels rise....if you had twins was a
>follow-up Beta done to see the levels go way up?? BTW slam away, just don't
>mess my hair k? ;)...keeps me humble. Did your patient also have hyperemesis
>or anything to suggest reaction to the rising levels? This is the downside
>of internet diagnosing...sometimes I just don't have the 'what-ifs' all in a
>row.
>Have a happy holiday. (if you haven't gotton my gift yet... a 14k watch will
>suffice *grin*)
>Janet
>>
>> buddy@redrose.net writes:
>>>With an HCG of 62,000 not only should an embryo be visualized but
>>>heart motion should also be observed. .... levels of 10,000 IU should
>>see heart motion...
>>
>>Dearheart Janet....
>>I got two cases 7-8k levels and no heartbeat.... negative adnexa, small
>>fundal fluid collections ??dicidual ring........so now what.... Lab says
>>... U/S should see the cardiac activity, if not they must be off... we
>>say we just calls them as we sees them, thank you for the slam, you must
>>be all knowing and right.....(not my words exactly:-)).... rising levels
>>no cardiac activity....must be ectopic.... not exactly
>>
>> In these two cases twin IUP's were discovered subsequently.... We
>>fought hard the methyltrexate route and won.... Some kids will never
>>know how close they were ;-) My belief was that the twins register
>>higher levels earlier.... anyone got a spin on this????
>>
>>Mark Lawson -- Texas
>>
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>>End of ULTRASOUND Digest 31
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