Re: Two Yolk Sacs, one embryo
From: Dave Berck (djberck@yahoo.com)
Wed Jan 22 08:17:10 2003
How could this be conjoined twins?
Conjoined twins are by definition monochorionic
monoamniotic and have 1 yolk sac. If there are two
yolk sacs, it is mono / di. Am I wrong?
--- "Terry J. DuBose" <duboseterryj@uams.edu> wrote:
> With "
> >LMP : 6 weeks and CRL 5 weks and 5 days.
> " and an EHR of 119 B/M which calculates to 5.9
> weeks or 5w6.7 days, the heart rate is absolutely
> normal for the age. The follow-up on Jan 31 will be
> 7.3 weeks, and I will predict that the hear rate
> will be near 151 at that time... and you will likely
> find a second CRL and heart rate that will be
> corresponding smaller and slower.
>
> Can't wait to here what happens. Terry
>
> ultrasound@obgyn.net writes:
> > Terry and friends
> >
> >I'm worry about conjoined twins possibility in this
> case.During scan I can't separate the two yolk
> sacs.I agree that in some days the other embrio will
> appear.Very interesting your article about EHR and
> IG.In this case the EHR of the embrio is 119 bpm.
> >Dr.Corda, the YS diameters is 3.7mm(embrio) and
> 3.5mm(non-embrio).
> >The patient will return in January 31.I'll post the
> follow up.
> >
> >Regards
> >
> >Mário
> >
>> >----- Original Message -----
> >From: [ mailto:duboseterryj@uams.edu ]Terry J.
> > DuBose
> >To: [ mailto:ultrasound@mail.medispecialty.com
> ]Multiple recipients of list
> > ULTRASOUND
> >Sent: Tuesday, January 21, 2003 9:23 PM
> >Subject: Re: Two Yolk Sacs, one embryo
> >
> >My first thought is that if you wait 3-4 days, the
> other twin will show up... I have seen cases where
> one twin was larger than the other by up to 6
> days... and their heart rates correlated with their
> CRL sizes both in the acceleration and deceleration
> phases. Our hypothesis was that when the cell mass
> split, one twin got a larger mass of cells. Both
> were normal, but remained about a week different in
> size until delivery. Check out this article:
> >
> >[
>
http://www.obgyn.net/english/pubs/features/dubose/ehr-age.htm
>
]http://www.obgyn.net/english/pubs/features/dubose/ehr-age.htm
> >particularly this image:
> >[
>
http://www.obgyn.net/english/pubs/features/dubose/Image16.gif
>
]http://www.obgyn.net/english/pubs/features/dubose/Image16.gif
> >
> >I also described this set of twins in detail in
> FETAL SONOGRAPHY, p. 151-154.
> >
> >Or you may need to watch for conjoined twins later.
> >
> >Either way, please follow this one, give us feed
> back... and get accurate measurement on the CRL and
> EHR over the next month. Interesting case.
> >
> >Good luck. Terry J DuBose.
> >
> >[ mailto:ultrasound@obgyn.net ]ultrasound@obgyn.net
> writes:
> >> Patient with 25 years old, G2P1A0, LMP : 6 weeks
> and CRL 5 weks and 5 days .
> >>
> >>US findings:
> >>Two yolk sacs side by side, but only one embryo
> identified.
> >>
> >>Opinions ?? Suggestions ???
> >>
> >>Regards
> >>Mário Libardi, M.D.
> >>Multimagem Ultra-sonografia
> >>Botucatu - Sao Paulo
> >>Brazil
> >
> >Peace, Terry J. DuBose, M.S., RDMS
> >Assistant Professor & Director, Diagnostic Medical
> Sonography Program
> >University of Arkansas for Medical Sciences, CHRP
> >4301 West Markham St. Mail Slot #563
> >Little Rock, Arkansas, 72205 USA
> >501-686-6510
> >[ mailto:DuBoseTerryJ@UAMS.edu
> ]DuBoseTerryJ@UAMS.edu
> >[ http://www.io.com/~dubose/
> ]http://www.io.com/~dubose/
> >[ http://www.uams.edu/CHRP/dmshome.htm
> ]http://www.uams.edu/CHRP/dmshome.htm
> >[ http://www.obgyn.net/us/panel/panel.htm
> ]http://www.obgyn.net/us/panel/panel.htm
> >
>
> Peace, Terry J. DuBose, M.S., RDMS
> Assistant Professor & Director, Diagnostic Medical
> Sonography Program
> University of Arkansas for Medical Sciences, CHRP
> 4301 West Markham St. Mail Slot #563
> Little Rock, Arkansas, 72205 USA
> 501-686-6510
> DuBoseTerryJ@UAMS.edu
> http://www.io.com/~dubose/
> http://www.uams.edu/CHRP/dmshome.htm
> http://www.obgyn.net/us/panel/panel.htm
>
=====
David J. Berck, MD, MPH
