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Re: 18 Week "Previa"From: CheriCNM@aol.comMon Sep 23 15:53:52 1996
In a message dated 96-09-20 12:49:54 EDT, rBraun@IUNET.IUPUI.EDU (R. Daniel Braun) writes:
<< Placentas are always firmly attached to the uterine wall and are never
peripatetic. The placenta never moves. Only our perception of the
placentas location changes from an early inaccurate perception to a later
accurate perception. The percption early is inaccurate because of the
procedure and nature. Not because the scan is misread.
>> My midwifery school mentor, the late James Green, MD, had a slightly different theory about "placental migration." He believed the likelier possibility is that the placenta, as it increases in size as the fetus grows and the pregnancy advances, develops assymetrically, in the direction of the richer endometrium toward the fundus, rather than continuing to grow symmetrically. He further believed that if you looked at the placentas which were identified in the second trimester as having been low-lying and/or partial previas you would find that many or most of them would exhibit a marginal cord insertion, rather than a more centrally located cord insertion. I always thought this made a lot of sense, though I've never conducted a systematic review of charts to see if these early U/S results were correlated with marginal cord insertions. I think it would be interesting, however. Cheri Van Hoover, CNM Kaiser Hospital Redwood City, CA
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