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Re: -post: Maybe still pregnant afterall???

From: R. Daniel Braun, MD (anonymous@obgyn.net)
Thu, 14 Dec 2000 20:08:13 -0600 (CST)

At Thu, 14 Dec 2000, Kimberly wrote: >
>LMP Oct. 3. My cycle is 26 days long. As of 9 wks, 3 days, my HCG
>level was 30,900. However, they did an ultrasound that didn't show a
>heartbeat, and it appears the embryo stopped developing at approx. 5
>weeks. The gestational sac appeared too large for the size of the
>embryo, but there was a fetal pole and all that, just no heart beat.
>
>At first, they told me it was definitely a blighted ovum, and
>recommended a D&C. Then, today, when I went to schedule the D&C,
>another doctor told me it wouldn't be unreasonable to request another
>ultrasound a week after the first one, just to be absolutely 100%
>certain. She seemed to be saying that there is a chance, albeit a slim
>one, that this might somehow turn out ok. In other words, maybe there
>would be a heartbeat if we gave it another week. She seemed to be
>basing this opinion on the date of my LMP and my HCG level more than
>anything else.
>
>Is this other doctor just more conservative in her approach and perhaps
>more sensitive to my emotional well-being? She said another ultrasound
>would mainly be to put my mind at ease, so I wouldn't wonder "what
>if..."
>

RIGHT. No heartbeat seen in a fetus that is well seen is as close to 100% as we can get.

>I guess my real question is, is there a chance here things are ok?

Seriously doubt it. I hope your Doc is right and proves me wrong, but.

Or is >the doc just doing this for my peace of mind? I didn't request another
>ultrasound, she offered. And the thing is, I don't really have any
>hope, as it seems SOMETHING is drastically wrong, even if they do find a
>heartbeat. The size for dates is just too small. Is it impossible for
>this to turn around and be "ok" afterall?

Not likely.

>
>Also, if the embryo DID develop (which it has), and then stopped
>developing, wouldn't it be considered a "missed miscarriage" and NOT a
>blighted ovum?

You are correct.

Why would the doc call it a blighted ovum even though the >embryo has obviously develeped (according to the ultrasound)?
>

Docs like other people frequently don't use the words correctly. I am a stickler for this and our residents get very exasperated with me harping about it. I keep on and I tell them that if they don't use the word corrrectly they will miscommunicate sometime and it may cause a problem. Every now and then it happens and I get to say SEE. Then they tolerate me for a while.

RDB

>Thanks for taking the time to answer my questions.

--
R. Daniel Braun, MD FACOG  FOG


This is for educational purposes only, and is not intended to be replacement or substitute for consultation and examination by an appropriate medical professional.  Due to time constraints, private e-mails cannot be answered.



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