Thanks to Dr Schechter for today’s review of the management and ultrasonography of the vaginal bleeder. As referenced, we believe in the discriminatory zone of B-HCG because, well, because we just do. But how helpful is it for distinguishing IUP vs ectopic pregnancy?
Read and learn.
http://www.ncbi.nlm.nih.gov.newproxy.downstate.edu/pubmed/21310509
The views expressed on this blog are the author's own and do not reflect the views of their employer. Please read our full disclaimer here. Any references to clinical cases refer to patients treated at a virtual hospital, Janus General Hospital.
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jfreedman
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Even though ,there is few weakness points ,There is more studies support this study findings
There have beens several case reports on women experiencing ectopics with serum B-Hcg quan levels less than 100. In clinical practice, if I had a suspected ectopic with no IUP or indeterminate IUP at any B-Hcg level, I would deem the diagnosis as an ectopic and treat the patient accordingly based on vitals, etc. I use the discriminatory zone to help me to determine what I should expect to see on either transab or endocav U/S. Looking forward to the discussion tomorrow.
On a random side note… see the current message on pubmed re governmental shutdown below! This is absolutely ridiculous. I guess all research will have to be halted until our political leaders learn how to play together in the sandbox.
“PubMed is open, however it is being maintained with minimal staffing due to the lapse in government funding. Information will be updated to the extent possible, and the agency will attempt to respond to urgent operational inquiries. For updates regarding government operating status see USA.gov.”
i agree with brenda. my thought process involves more of the clinical picture than cut-offs.. Is she stable? How are the vitals? per dates, would we expect to see an iup on beside? if we dont and would expect to:
-unstable/heavy bleeding/pain- consult OB!!!
-stable/minimal bleeding/no pain– Formal US
Dr. Schechter is going to be on fire today…