OB-GYN-L Messages for January, 2005: Re: Birth defect legal question

Re: Birth defect legal question

From: art fougner, md

evsono@pipeline.com

Mon Jan 31 09:30:59 2005

False diagnosis of renal agenesis on fetal MRI M. Sgro 1, V. Shah 2, T. Barozzino 1, K. Ibach 3, L. Allen 4, D. Chitayat 5 * 1Department of Pediatrics, St. Michael's Hospital, University of Toronto, Ontario, Canada 2Department of Pediatrics, Mount Sinai Hospital, University of Toronto, Ontario, Canada 3Department of Diagnostic Imaging, Mount Sinai Hospital, University of Toronto, Ontario, Canada 4Department of Obstetrics and Gynecology, Mount Sinai Hospital, University of Toronto, Ontario, Canada 5The Prenatal Diagnosis and Medical Genetics Program, Mount Sinai Hospital, University of Toronto, Ontario, Canada email: D. Chitayat (dchitayat@mtsinai.on.ca)

*Correspondence to D. Chitayat, The Prenatal Diagnosis and Medical Genetics Program, Mount Sinai Hospital, Ontario Hydro Generation Building, 700 University Avenue, 3rd floor, Rm. 3292, Toronto, Ontario, Canada

Abstract We report a twin pregnancy in which prenatal ultrasound revealed anhydramnios and bilateral absence of the kidneys in both fetuses. To overcome the difficulties faced in obtaining accurate information on fetal ultrasound in cases with oligohydramnios, an attempt was made to use fetal magnetic resonance imaging (MRI) to confirm the renal status. However, while the fetal MRI showed renal agenesis in both twins, postnatal follow-up revealed that one twin, which survived, had a small unilateral kidney not seen antenatally on fetal ultrasound or MRI. The second twin had bilateral renal agenesis and died of pulmonary hypoplasia. Care should be taken when using fetal MRI to replace fetal ultrasound in cases with poor visibility. Copyright Š 2004 ISUOG. Published by John Wiley & Sons, Ltd. Accepted: 29 July 2004

All i'm saying is that 100% predictive value remains elusive.

art

At Mon, 31 Jan 2005, dr.jefferson wrote: >
>I think that there's a lot of exceptions. May I suggest one
>if you have a patient taking Talidomida the baby will show a
>image on USG (no legs or arms) and the cause is clear.
>
>Jefferson Delfino
>
>> In a message dated 1/30/05 8:08:48 AM, evsono@pipeline.com
>
>writes:
>>
>> > Anencephaly might be the exception - however, i've seen
>
>bpd's measured
>> > on anencephalics - go figure.
>> >
>>
>> You've got to have a really good U/S machine and a really
>
>good sonographer to
>> get those BPDs on an anencephalic.
>>
>> Joe P.
>>
>__________________________________________________________________________
>Acabe com aquelas janelinhas que pulam na sua tela.
>__________________________________________________________________________
>
>--
>__________________________________________________________________________
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>__________________________________________________________________________
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>

-- art fougner, md

"If you don't know where you are going, you will wind up somewhere else." Lawrence Peter Berra

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