Sonoembryology

Q.1. What is blighted ovum? : - Ans: - if no Y sac is visible in TVS but GSD is very much > 8 mm Q.2. What is meant by anembryonic preg?-Ans: - when GSD is > 18-23 mm but foetal poles are not demonstrable in TVS, Q.4. How one correlate CRL with menst age –as calculated from LMP- 1) For CRL of 10 mm, 30 mm, 60 mm implies 7 weeks, 9.5 weeks & 12.3 weeks respectively.

What are the sonological signs of failing IUP (inra-uterine preg)/ poor viability scan? a) Embryonic bradycardia in relation to CRL & GSD b) oligo-amnios-less LA in gest sac c) growth profile of sac: - speed is less than normal growth of sac d) large 

 What is meant by Biochemical preg: - when two successive estimation of beta HCG reveals a figure > 10 IU/L, and if no sac is visible then biochemical pregnancy after 6 weeks. But when sac is demonstrable it qualifies for clinical preg.

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 :: Learn more about beta h-CG:- Learning point-1:- On the day of missed period – in fertile cycle the serum beta hCG wail be about 100 mIU/ml or 100 IU/L.. On day 35 beta HCG will be somewhere 200-400, at day 45 of menst age= beta HCG will be 20-4,000, at 12 weeks= 10,000 is normal (but if one likes to convert into IRP =Inter Reference Preparations then multiply with 1.5 = this will yield in IRP. UPT will be +ve 13 days after ovulation, RIA of hCG will be +ve in sera 9 days after ovulation, If one have trigger with β-hCG then if necessity arises one should 5 dues after last trigger dose –to clear off the exogenous hCG. Additionally if serum beta HCG is > 1500 i.u. in TVS sac should be visible, and by TAS sac may be visible only when β-hCG is ≥ 3000 i.u. I non preg sate the serum β-hCG ranges from 0.02-0.80 i.u /L; menopauses 1-5 and in males β-hCG ranges from≤ 2.5 i.u/L.

Unless beta HCG is > 1500 IU it will be impossible to view the sac. Hopefully,the sac will appear after 1-2 weeks time. AS because coupe don't like to have pregnancy therefore I shall strongly suggest for 1 dose of MTX 50 mg IM ,provided her Heamogram, leukocyte cunt in articular ,are normal. This will hopefully end the matter. Pl follow up with UPT only. Later may counsel for COC if no contraindications. for details of sono-embryology-appearance of chronological appearance of of C changes, SAC appearances, Foetal poles-details , FHR etc in relation to Chronology of beta HCG in relation to GSD & CRL, Menst age & Ovulation in particular.