Manual of Obstetric Emergencies by Dobiesz Valerie;Kerrigan Kathleen; & Kathleen A. Kerrigan

Author:Dobiesz, Valerie;Kerrigan, Kathleen; & Kathleen A. Kerrigan
Language: eng
Format: epub
Publisher: Wolters Kluwer Health
Published: 2020-01-15T00:00:00+00:00

Figure 14.3: Bedside ultrasound showing a partial molar pregnancy with empty anechoic sac, large and stormy intrauterine mass.

Figure 14.4: Ultrasound showing multiple vesicular endometrial structures consistent with a complete molar pregnancy. A 26-year-old presented at 10 weeks’ gestation with irregular vaginal bleeding. Serum human chorionic gonadotropin was 120 000 mIU/mL.

The highly vascularized tumors of GTD may be evaluated with the Doppler function. Persistent neoplasia is seen as a focal myometrial lesion appearing hypervascularized and often hyper- or hypoechoic, or even as a complex or multicystic mass.44 It may also prove useful in evaluation of invasive disease as both abnormal myometrial vascularization and increased uterine artery Doppler indices are correlated with invasive disease and are associated with methotrexate resistance.44,48

Chest Radiography

Chest radiography is part of the FIGO lung metastasis staging recommendations and is used as an initial screening tool to identify and count the number of lung metastases (Figure 14.5).5 It has merit in the emergency setting to establish a baseline and to serve as a reference point for further treatment and in discussion of patient care with consulting physicians. It should be noted though that up to 41% of patients who have evidence of lung metastasis seen on chest computed tomography (CT) scan will have a normal chest radiograph.44

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