RIU 332 Lecture 39: First Trimester Complications pt 4
26 Mar 2020
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Choriocarcinoma- malignant form of trophoblastic disease that occurs in 2% to 3% of molar pregnancies. Tumor fast growing; commonly metastasizes to lungs, liver, brain. Clinical symptoms include vaginal bleeding in addition to dyspnea, abdominal pain, and neurologic symptoms, depending on where metastasis spread. Identifying iup with or without cardiac activity is first conclusive sonographic sign of viability. With transvaginal sonography, living embryo should be detected by 46 menstrual days. More than one sonogram may be necessary to establish normal pregnancy. Absence of cardiac activity in first trimester is most critical sign for viability of pregnancy. Heart tube formed between 3. 5 and 5 weeks of conception. Tvs- when crl measures 4mm, embryo should demonstrate. Once cardiac activity seen, m-mode should be used to record cardiac function actual heart rate. If embryo visible by sonography but cardiac activity cannot be documented, prognosis poor.
