Query on report on possibly Trophoblastic disease

Patient

Q: I had an ultrasound report like this "there is a single intrauterine gestational sac with a mean sac diameter of 6mm. There is a normal-appearing yolk sac. No foetal pole or active foetal heart beat can be see at present. No subchorionic haemorrhage . The cervix is closed. There is an ill-defined slightly heterogeneous and echogenic abnormal appearance to the uterine myometrium, which is difficult to clearly define, measuring approximately 52 x 41 x 26mm. Neither ovary could be identified. No free fluid in the pouch of Douglas." Comment: There is an early single intrauterine pregnancy, however, viability has not been confirmed. There is an abnormal appearance to the myometrium, which raises the remote possibility of trophoblastic disease. specialist review is recommended.

Sorry for the long question. My wife also has poly-cystic ovary with irregular periods, would this cause the myometrium to be abnormal? And I suspect that the GP we see determined the wrong weeks of pregnancy hcg was 600 2 weeks before the ultrasound, thus it might be too early to find the heart beat, GP thinks that she is 7 weeks pregnant when having ultrasound, but I think she is 5 weeks only. I am booking an OBGYN anyway

Symptoms:  Pregnancy
Doctor

A:   Hello,
Thanks for the query,

As the scan shows 6 weeks and there is no foetal pole or yolk sac yet it is too early to comment on the viability of the foetus. If there is a concern regarding the shape of myometrium and its thickness then trophoblastic disease can be ruled out by getting the beta hCG levels done. The levels have to be more than ONE LAKH for confirming GESTATIONAL TROPHOBLASTIC DISEASE.
Please visit your physician for a review. I suggest a repeat USG after 2 weeks to look for foetal pole and foetal heart rate.

Regards

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