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Re: 18 Week "Previa" -Reply -Reply- ReplyFrom: T Dubose (tjdubose@chrp.uams.edu)Thu Sep 26 18:31:39 1996
I will slightly disagree with the uterine growth model. Some of the apparent change in the relative position of the placenta may be due to uterine growth, however I accept Fineberg+s hypothysis that most of the change is due to the growth of the placenta. The placental attachments do not move. However, they do exhibit trophotropism in that there is a propensity to grow toward nutritive blood supplies and away from diminished supply. Trophotropism simply and elegantly explains marginal and velamentous insertions, vasa previa, succenturiate lobes and a number of placental oddities. This has been researched and discussed by Fineberg HJ (Arizona), The placenta and umbilical cord: Recent observations. Lecture and SDMS official proceedings, 10th Annual SDMS Conference, Anaheim, CA, 1993; p. 241. Also, see DuBose TJ, Fetal Sonography, W. B. Saunders Co, Philadelphia, 1996, p. 362. I realize that much of this is repeated, however it seems to have been ignored in the current discussion. If anyone feels the trophotrophic explanation is completely off the wall, then please point out the error. Thanks Terry J. DuBose, M.S., RDMS; Assistant Professor Program Director, Diagnostic Medical Sonography University of Arkansas for Medical Sciences, tjdubose@chrp.uams.edu http://www.io.com/~dubose/ VOICE: 501-686-6510 FAX: 501-686-5613 Now It is my understanding that the position of the placenta changes because of differential growth of the uterus. Therefore, the segment of uterus making up the lower uterine segment early on in gestation can end up in the upper segment as the uterus grows. Robert Brenner MD Baltimore MD Robbrenner@earthlink.net I concur, but I take exception to the idea that it is attached on both sides of the cervix going across the cervical os, and then because of enlargement of the uterus is only attached on one side of the cervix. Think about it. R.Daniel Braun, MD FACOG Department of OB/GYN Indiana U. School of Medicine OBGYN.net, International Representative, U.S.
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