Chapter 1041 Menstrual period and pregnancy coexist?
In the emergency room.
The girl has been transferred to the bed. During the process, she cried out in pain intermittently. After questioning, she said that she did feel a vague abdominal pain. Most of the time, there was no great pain, but it would be much more obvious when she moved more.
"Pregnancy? Ectopic pregnancy?" This was Shi Lian's first thought.
In fact, this is also a guess that any first-time visitor will inevitably make. Whether it is a medical staff or not, it is easy to associate it with this aspect.
A woman of childbearing age, a swollen abdomen, abdominal pain... if it is not an ectopic pregnancy, what is it?
Of course, it may also be a tumor in the stomach.
However, the doctor on the car, the girl and her parents all denied it.
The reason is very simple. Not only is the other party still having her period, but now it is her period...
"Go and confirm it." Xu Qiu said.
Although according to the family members and the patient herself, this time point just fits the cycle of the menstrual period, but what if it is?
For ordinary people, it is not necessarily easy to distinguish between menstrual bleeding and bleeding due to other reasons.
After all, the book says "dark blood", "bright red", "thick blood", etc., but this is just theory, and it may not be easy for ordinary people to judge.
Just like everyone knows the liver in the picture, but in the operation, facing a pile of bloody meat lumps squeezed together, it is impossible to identify the tissue structure.
Swish--
Pull up the screen, and soon, Shi Lian came out.
She nodded and said, "Teacher, it is indeed her menstrual period."
This basically ruled out the possibility of pregnancy.
"How long has this situation been?" Xu Qiu turned to ask the family members.
"It's not clear, it seems to have been a while, her belly is slowly getting bigger... But it's definitely not pregnancy, it's her period!" The mother of the family member argued fiercely.
Obviously, this is a very traditional parent who cannot accept that her daughter is related to such things, and even wants to try her best to clear the possible stigma.
But after listening to this narration, Xu Qiu frowned slightly.
Young women, abdominal pain, abdominal distension...
If these three items are combined with an acute onset, and then the liver is touched, it can actually be directly considered as portal hypertension ascites.
For example, cardiac ascites, portal hypertension, myxedema caused by hypothyroidism, etc., may all be the cause.
It may even be a malignant tumor, tuberculous peritonitis, etc.
If you really think about it from this angle, you only need to measure the serum ascites albumin gradient to make a basic judgment.
But the result is not an acute onset?
Xu Qiu did not take the family's words as the only basis.
He first went behind the screen and palpated the abdomen, but did not feel an enlarged liver.
"... No?"
This surprised Xu Qiu.
After thinking for a moment, Xu Qiu said: "Check the blood HCG."
"Huh?"
Shi Lian was slightly stunned.
But only a moment later, she immediately agreed: "Okay, I will explain to the family."
However, after informing the family of this examination item, the reaction there was surprisingly strong.
"No, do you know how to treat a doctor? You're checking if you're pregnant when you're having your period? You'll stop menstruating if you're pregnant, don't you understand?"
"You're ordering random tests, right? I've already turned on the video. Now tell me again, did you find out that my daughter is on her period? Are you planning to check if she's pregnant now?"
The aggressive tone made Shi Lian panic.
Although she has an extraordinary talent in medicine, she's only in her twenties after all.
Because she's obsessed with surgery, she doesn't have much experience communicating with family members, not to mention that she's encountered some difficult people.
So at the moment, Shi Lian's momentum weakened a lot, and she subconsciously wanted to find Xu Qiu.
Just at this moment, Xu Qiu, with a calm face, also came over.
Although he didn't say a word, when he stood between Shi Lian and the family members, the latter's arrogance suddenly died down.
And she took the initiative to compromise, her tone softened, and she said, "Doctor, your examination is unreasonable..."
Hearing that the other party was willing to communicate, Xu Qiu's indifference on his face instantly subsided, and he showed a warm smile when facing the patient, saying, "In theory, pregnancy and menstruation cannot exist at the same time. But there are always exceptions."
For example, biochemical pregnancy.
This means that the sperm and egg have combined, but because they have not implanted in the uterine cavity, or implantation fails, in the end, although HCG can be detected to be higher than the normal value or the urine pregnancy test is positive, there is actually no pregnancy.
It is also called "hidden abortion".
Even, the patient may not know that she has been pregnant before, but the amount of tidal blood is a little more during a certain period of time, and the embryo that failed to implant has already flowed out invisibly.
Of course, this only refers to one of the situations where "pregnancy and menstruation" coexist, and it does not actually apply to this female high school student.
From her bulging belly, it is at least seven or eight months, which definitely does not meet the standard of biochemical pregnancy.
Even so, Xu Qiu could think of several possibilities to explain the current situation, but these speculations were too bizarre and rare, so he did not elaborate.
"In short, from a medical point of view, menstruation and pregnancy are not absolutely isolated, but can indeed coexist...
"On the one hand, a pregnancy test is an accurate screening, and on the other hand, it is an auxiliary diagnosis to guide other disease indicators."
Xu Qiu said it very carefully this time.
After all, HCG can actually be used as an auxiliary diagnosis of malignant tumors such as hydatidiform mole and choriocarcinoma in addition to pregnancy, and some endocrine metabolic diseases, such as pituitary disease and hyperthyroidism, may also cause pathological HCG changes.
Pregnancy is just one of the identification items.
"If it is too expensive, you can do a urine pregnancy test, which only costs a dozen yuan per test." Xu Qiu said.
Compared with the blood pregnancy test of more than 100 yuan, the accuracy and sensitivity of the urine pregnancy test will decrease a lot, but the price is also extremely low.
Hearing this, the family members no longer struggled and hurriedly said: "Just do the expensive one, this money is still affordable, we are just worried about the child..."
"Okay, go and pay the fee." Xu Qiu said no more.
Until the family members left, the parents were still a little dizzy.
Although they were a little convinced before, why did they suddenly agree to do a pregnancy test?
Shi Lian was also a little surprised.
I didn't expect that the family member who was so arrogant just a moment ago would compromise after just a few words?
Xu Qi smiled.
This is actually just a small skill in communication.
If you ask the other party whether to do the examination, most people will definitely choose not to do it.
However, if two examinations are put on display, one expensive and one cheap...
For Daxia-style parents, with the idea of "why can't the children suffer", they will no longer worry about the examination itself, but choose the more expensive one.
This is the famous... examination effect.
"I see."
Shi Lian nodded seriously. She is indeed still a long way from the teacher.
But compared to this, she is more curious about why the teacher insists on checking HCG.
Do you really suspect that pregnancy and menstruation exist at the same time?
