The clinical diagnosis of the narcoleptic syndrome

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Title:	The clinical diagnosis of the narcoleptic syndrome
Authors:	Parkes, JD;Chen, SY;Clift, SJ;Dahlitz, MJ;Dunn, G
Contributors:	附設醫院精神醫學部;Univ London Kings Coll, Sch Med & Dent, Dept Clin Neurosci, London, England;China Med Coll Hosp, Dept Psychiat, Taichung, Taiwan;Inst Psychiat, Dept Biostat & Comp, London, England
Date:	1998
Issue Date:	2010-09-24 14:51:56 (UTC+8)
Publisher:	BLACKWELL SCIENCE LTD
Abstract:	BACKGROUND: Intramural pregnancy is the rarest form of ectopic pregnancy. The diagnosis depends upon the sonographic finding of intramural gestational sac-like growth and persistent high beta-human chorionic gonadotropin (beta-hCG) levels after dilatation and curettage. No authors mentioned negative beta-hCG result in such situation. Rarely has the literature contained preoperative sonograms and photographs of postoperative gestational tissue. CASE: A 31-year-old woman presented with vaginal spotting for five months. Six months earlier she underwent dilatation and curettage for blighted ovum at 8 weeks' gestation. Since then, incidental vaginal spotting was noted. Sonography demonstrated all intramural cyst with fetal pole-like growth. Serum beta-hCG, diagnostic dilatation and curettage, and hysteroscopic examination were negative. Laparotomy for excision of the cyst confirmed an intramural pregnancy. CONCLUSION: Because of the long period after fetal wastage, negative serum beta-hCG was noted in this case. Negative serum beta-hCG was unreliable in the exclusion of intramural pregnancy. With the sonographic appearance of intramural gestational sac-like growth, in spite of a negative serum beta-hCG the clinician should be alert to the possibility of intramural pregnancy.
Relation:	JOURNAL OF SLEEP RESEARCH 7(1):41-52
Appears in Collections:	[China Medical University Hospital] Jurnal articles

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