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=?WINDOWS-1252?Q?Re:_Interesting_pregnancy_case_–_suggestions??In-Reply-To: <1179356160.464b8c00b2e6f@webmail.thehuffpeople.net> From: R. Daniel Braun (rd.braun@gmail.com) Wed May 16 21:41:43 2007 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: R. Daniel Braun: "Re: All in a Day's Work!" Previous message: R. Daniel Braun: "Re: VBAC question" Quiot measuring the hCG. It will only cause you to do something you shouldn't. I have seen normal singleton pregnancies that had an hCG of 135,000 mIu/ml, John's diferential seems to be fairly complete. Follow with frequent U/S and watch for early onset toxemia. Dan On 5/16/07, Dean Huffman . <dean@thehuffpeople.net> 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? > -- R. Daniel Braun, MD FACOG(L) CMT Professor Emeritus Dept. of Obstetrics and Gynecology Indiana U. School of Medicine -- R. Daniel Braun "The way to health is an aromatic bath and scented massage everyday".. Hippocrates Next message: R. Daniel Braun: "Re: All in a Day's Work!" Previous message: R. Daniel Braun: "Re: VBAC question"

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