EPs can pretty reliably be diagnosed by blood testing of HCG combined with ultrasound testing. Actually it’s easier to rule out than in. And some cases are just plain easier to diagnose. There are pregnancies that have such a high HCG with no visible ultrasound presence of pregnancy in the uterus the diagnosis is fairly clear. And there are other pregnancies in which the numbers do not climb at all with no pregnancy in the uterus. Both pretty clearly tubal pregnancies (for the most part). Then we have those that have a low enough hormone level we aren’t sure if it’s just a newly started pregnancy or one that has very abnormal hormone production because it’s not in the right place. For those we look at the “doubling time.” Most normal pregnancies will have their placental hormone HCG double in 48 hours. But some won’t and we used to say they should at least rise about 66%. But new data says that some healthy pregnancy can even have hormone levels that rise more slowly than that…only 53% over the two days. Making 53 the old 66.
Decidual Cast Periods can be fairly easy, passing some tissue at a time, or off can come the whole lining in one piece called a decidual cast. Generally the lining of the uterus is only 6-8 mm thick at the time of the menstrual period, and it is shed gradually, a few cells at a time. The decidual cast is when the entire lining passes spontaneously. It's not uncommon, but it usually both uncomfortable, and alarming to some. But us women are designed to have some sort of periods Or Not? We have to pass tissue each month. Or Not? Are they good for us? Or Not? Do we want them? Or Not? Is this something that is individual? Or Not? It's a complex topic that I will be discussing a lot over my time in this blog. So lets start with basics: How much do we bleed and what are we loosing, and just what was this that the patient passed? And another basic: track your periods, and the Women's Health Practice site http://www.womenshealthpractice.com/media/pdf/menstrual_chart.pdf you
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