Re: ULTRASOUND digest 2786
From: Beithon, Jill (jill.beithon@siemens.com)
Wed May 21 23:36:29 2008
Good evening from Minnesota,
Besides the educated attention to detail by the skilled hands performing
the measurements, it is also very important to consider the charts and
formulas used to calculate the EFW after we input the numbers. Results
based on complicated regression formulas still must have had normal
ranges which they were designed from which had to have had taken into
account geographic populations. How accurate can any of us be on the EFW
of any given fetus considering we, and the authors of the charts we use,
come from different parts of the country or the world? And who of us are
absolutely positive which formulas our machines use? Hadlock had many
different weight formulas. And the formulas vary depending on which
parameters we input. Yikes! It's pretty complicated.
With that being said I wholeheartedly agree that proper training and
careful scanning certainly improve EFW results. Is anyone out there
working on charts which use volumetric measurements? That will be cool!
Jill Beithon RT, RDMS, RDCS, RVT
________________________________
From: ultrasound@obgyn.net [mailto:ultrasound@obgyn.net] On Behalf Of
--
________________________________
Sue Davies
Sent: Wednesday, May 21, 2008 10:46 PM
To: Multiple recipients of list ULTRASOUND
Subject: Re: ULTRASOUND digest 2786
Hi Guys
I don't often contribute to this forum but here goes, I'll weigh into
this one! Many years ago (1979) we did a prospective study on EFW, with
very tight guidelines and criteria (too long to go into here). The
results showed that, in our hands (well trained, careful sonographers
with a strict attention to detail), the EFW by ultrasound was within +/-
50gms. I would imagine that, were the study to be repeated, we would be
even better nowadays with modern sensitive equipment at our fingertips.
I'm with you Terry - don't knock something unless you are prepared to do
it properly, ultrasound fetal measurement is not a slapdash procedure,
it should be undertaken with much care and attention. Those who are
properly trained will do the best job.
Cheers
Sue
From: ultrasound@obgyn.net [mailto:ultrasound@obgyn.net] On Behalf Of
Terry DuBose
Sent: Thursday, 22 May 2008 12:29 PM
To: Multiple recipients of list ULTRASOUND
Subject: Re: ULTRASOUND digest 2786
Art, you are correct, weight is given by a scale, that is difficult with
a fetus.
An estimate does have more variance than a measurement by scale; but a
good sonographic instrument, in skilled hands can reduce the variance.
A sonographic estimate by a skilled operator is more than a guess. IMHO.
And as people understand volumetric fetal measurements, the variance
will be reduced more.
Peace, Terry
evsono@pipeline.com wrote:
If you want to find out how much you weigh, you get on a scale.
You don't measure your waistline. Estimate is just a fancy word for
guess.
Of course, that's just my opinion. I could be wrong.
-----Original Message-----
From: ultrasound@obgyn.net
Subj: ULTRASOUND digest 2786
Date: Wed May 21, 2008 9:21 pm
Size: 25K
To: Multiple recipients of list ULTRASOUND
ULTRASOUND Digest 2786 Topics covered in this issue include: 1)
RE: EFW accuracy by "DuBose, Terry" 2) RE: EFW accuracy by Dave Berck
----------------------------------------------------------------------
Date: Wed, 21 May 2008 09:39:47 -0500 From: "DuBose, Terry" To:
----------------------------------------------------------------------
ultrasound@obgyn.net, "Multiple recipients of list ULTRASOUND" Subject:
----------------------------------------------------------------------
RE: EFW accuracy Message-ID: Content-class: urn:content-classes:message
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boundary="----_=_NextPart_001_01C8BB50.85285723" This is a multi-part
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quoted-printable I suspect the reason sonographic measurements are
considered so questionable is that there are so many people using
sonography who do not have rigorous training and do not practice precise
methods. Many seem to think precise measurement methods are not
necessary because "ultra!
sound" is
not considered accurate, a sort of self-fulfilling problem.
In a lawsuit in which I was an expert witness, a case very similar
the one under current discussion, the sonographer has attended an
unaccredited, = short course of study, was not credentialed by the
ARDMS, and was on-call by herself. It was obvious she had measured the
abdominal circumference at = the ribs and spine in back, completely
excluding the skin, baby fat, and muscles in back. The vaginal delivery
also ended up with dystocia and neurological damage in the neonate.
It is my opinion that sonography, in the hands of a skilled
sonographer, is much more accurate than it is given credit for being.
But many simply do not take the time and/or do not have the
understanding and skill to use it effectively. I would like to
see how the measurements in the case under current = discussion were
actually made. We also need to be moving to volumetric measurements, the
fetus does not liv!
e in "Fla
t Land"... and the head molds considerably, especially in the
vertical axis due to the sutures and fontanels. Terry J. DuBose,
M.S., RDMS, FSDMS, FAIUM Associate 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 or 501-686-5948 DuBoseTerryJ@UAMS.edu
http://www.uams.edu/chrp/sonography/
http://www.obgyn.net/us/panel/panel.htm http://www.io.com/~dubose/
---------------------------------------------------------------
[mailto:ultrasound@obgyn.net] On Behalf Of Dave Berck Sent: Tuesday, May
---------------------------------------------------------------
20, 2008 4:46 PM To: Multiple recipients of list ULTRASOUND Subject: Re:
---------------------------------------------------------------
EFW accuracy true David J. Berck, MD, MPH -----
Original Message ---- From: "DoctorJoe@aol.com" To: Multiple
recipients of list ULTRASOUND Sent: Tuesday, May 20, 2008 4:39:17 PM
Subjec!
t: Re: EF
W accuracy In a message dated 5/20/08 1:57:45 PM,
djberck@yahoo.com writes: comparison was made between U/S EFW, Leopold's
, and Maternal estimates of EFW. The maternal estimates were the most
accurate. Only mother's who had already had one pregnancy already (I
Confidentiality Notice: This e-mail message, including any attachments,
is = for the sole use of the intended recipient(s) and may contain
confidentia= l= and privileged information. Any unauthorized review,
use, disclosure or = distribution is prohibited. If you are not the
intended recipient, please = contact the sender by reply e-mail and
destroy all copies of the original = message.
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<DIV dir=ltr align=left><SPAN class)1585003-22052008><FONT face=Arial
color=#0000ff size=2>Good evening from Minnesota,</FONT></SPAN></DIV>
<DIV dir=ltr align=left><SPAN class)1585003-22052008><FONT face=Arial
color=#0000ff size=2></FONT></SPAN> </DIV>
<DIV dir=ltr align=left><SPAN class)1585003-22052008><FONT face=Arial
color=#0000ff size=2>Besides the educated attention to detail by the skilled
hands performing the measurements, it is also very important to consider the
charts and formulas used to calculate the EFW after we input the
numbers. Results based on complicated regression formulas still must
have had normal ranges which they were designed from which had to have had
taken into account geographic populations. How accurate can any of us
be on the EFW of any given fetus considering we, and the authors of the
charts we use, come from different parts of the country or the world? And
who of us are absolutely positive which formulas our machines use?
Hadlock had many different weight formulas. And the formulas vary depending on
which parameters we input. Yikes! It's pretty
complicated. </FONT></SPAN></DIV>
<DIV dir=ltr align=left><SPAN class)1585003-22052008><FONT face=Arial
color=#0000ff size=2></FONT></SPAN> </DIV>
<DIV dir=ltr align=left><SPAN class)1585003-22052008><FONT face=Arial
color=#0000ff size=2>With that being said I wholeheartedly agree
that proper training and careful scanning certainly improve EFW
results. Is anyone out there working on charts which use volumetric
measurements? That will be cool!</FONT></SPAN></DIV>
<DIV dir=ltr align=left><SPAN class)1585003-22052008><FONT face=Arial
color=#0000ff size=2></FONT></SPAN> </DIV>
<DIV dir=ltr align=left><SPAN class)1585003-22052008><FONT face=Arial
color=#0000ff size=2>Jill Beithon RT, RDMS, RDCS, RVT</FONT></SPAN><BR></DIV>
<DIV class=OutlookMessageHeader lang=en-us dir=ltr align=left>
<HR tabIndex=-1>
<FONT face=Tahoma size=2><B>From:</B> ultrasound@obgyn.net
[mailto:ultrasound@obgyn.net] <B>On Behalf Of </B>Sue Davies<BR><B>Sent:</B>
Wednesday, May 21, 2008 10:46 PM<BR><B>To:</B> Multiple recipients of list
ULTRASOUND<BR><B>Subject:</B> RE: ULTRASOUND digest 2786<BR></FONT><BR></DIV>
<DIV></DIV>
<DIV class=Section1>
<P class=MsoNormal><SPAN
style="FONT-SIZE: 11pt; COLOR: #1f497d; FONT-FAMILY: 'Calibri','sans-serif'">Hi
Guys<o:p></o:p></SPAN></P>
<P class=MsoNormal><SPAN
style="FONT-SIZE: 11pt; COLOR: #1f497d; FONT-FAMILY: 'Calibri','sans-serif'">I
don’t often contribute to this forum but here goes, I’ll weigh into this one!
Many years ago (1979) we did a prospective study on EFW, with very tight
guidelines and criteria (too long to go into here). The results showed that, in
our hands (well trained, careful sonographers with a strict attention to
detail), the EFW by ultrasound was within +/- 50gms. I would imagine that, were
the study to be repeated, we would be even better nowadays with modern sensitive
equipment at our fingertips.<o:p></o:p></SPAN></P>
<P class=MsoNormal><SPAN
style="FONT-SIZE: 11pt; COLOR: #1f497d; FONT-FAMILY: 'Calibri','sans-serif'"><o:p> </o:p></SPAN></P>
<P class=MsoNormal><SPAN
style="FONT-SIZE: 11pt; COLOR: #1f497d; FONT-FAMILY: 'Calibri','sans-serif'">I’m
with you Terry – don’t knock something unless you are prepared to do it
properly, ultrasound fetal measurement is not a slapdash procedure, it should be
undertaken with much care and attention. Those who are properly trained will do
the best job.<o:p></o:p></SPAN></P>
<P class=MsoNormal><SPAN
style="FONT-SIZE: 11pt; COLOR: #1f497d; FONT-FAMILY: 'Calibri','sans-serif'">Cheers<o:p></o:p></SPAN></P>
<P class=MsoNormal><SPAN
style="FONT-SIZE: 11pt; COLOR: #1f497d; FONT-FAMILY: 'Calibri','sans-serif'">Sue<o:p></o:p></SPAN></P>
<P class=MsoNormal><SPAN
style="FONT-SIZE: 11pt; COLOR: #1f497d; FONT-FAMILY: 'Calibri','sans-serif'"><o:p> </o:p></SPAN></P>
<DIV
style="BORDER-RIGHT: medium none; PADDING-RIGHT: 0cm; BORDER-TOP: #b5c4df 1pt solid; PADDING-LEFT: 0cm; PADDING-BOTTOM: 0cm; BORDER-LEFT: medium none; PADDING-TOP: 3pt; BORDER-BOTTOM: medium none">
<P class=MsoNormal><B><SPAN lang=EN-US
style="FONT-SIZE: 10pt; FONT-FAMILY: 'Tahoma','sans-serif'">From:</SPAN></B><SPAN
lang=EN-US style="FONT-SIZE: 10pt; FONT-FAMILY: 'Tahoma','sans-serif'">
ultrasound@obgyn.net [mailto:ultrasound@obgyn.net] <B>On Behalf Of </B>Terry
DuBose<BR><B>Sent:</B> Thursday, 22 May 2008 12:29 PM<BR><B>To:</B> Multiple
recipients of list ULTRASOUND<BR><B>Subject:</B> Re: ULTRASOUND digest
2786<o:p></o:p></SPAN></P></DIV>
<P class=MsoNormal><o:p> </o:p></P>
<DIV>
<P class=MsoNormal>Art, you are correct, weight is given by a scale, that is
difficult with a fetus. <o:p></o:p></P></DIV>
<DIV>
<P class=MsoNormal> <o:p></o:p></P></DIV>
<DIV>
<P class=MsoNormal>An estimate does have more variance than a measurement by
scale; but a good sonographic instrument, in skilled hands can reduce the
variance. A sonographic estimate by a skilled operator is more than a
guess. IMHO. And as people understand volumetric fetal measurements, the
variance will be reduced more. <o:p></o:p></P></DIV>
<DIV>
<P class=MsoNormal> <o:p></o:p></P></DIV>
<DIV>
<P class=MsoNormal>Peace, Terry <BR><BR><B><I>evsono@pipeline.com</I></B>
wrote:<o:p></o:p></P></DIV>
<BLOCKQUOTE
style="BORDER-RIGHT: medium none; PADDING-RIGHT: 0cm; BORDER-TOP: medium none; MARGIN-TOP: 5pt; PADDING-LEFT: 4pt; MARGIN-BOTTOM: 5pt; PADDING-BOTTOM: 0cm; MARGIN-LEFT: 3.75pt; BORDER-LEFT: #1010ff 1.5pt solid; PADDING-TOP: 0cm; BORDER-BOTTOM: medium none">
<P class=MsoNormal style="MARGIN-BOTTOM: 12pt">If you want to find out how
much you weigh, you get on a scale. You don't measure your waistline. Estimate
is just a fancy word for guess.<BR><BR>Of course, that's just my opinion. I
could be wrong.<BR><BR>-----Original Message-----<BR><BR>From:
ultrasound@obgyn.net<BR>Subj: ULTRASOUND digest 2786<BR>Date: Wed May 21, 2008
9:21 pm<BR>Size: 25K<BR>To: Multiple recipients of list ULTRASOUND
<BR><BR>ULTRASOUND Digest 2786 Topics covered in this issue include: 1) RE:
EFW accuracy by "DuBose, Terry" 2) RE: EFW accuracy by Dave Berck
---------------------------------------------------------------------- Date:=20
---------------------------------------------------------------------- Wed, 21 May 2008 09:39:47 -0500 From: "DuBose, Terry" To:=20
---------------------------------------------------------------------- ultrasound@obgyn.net, "Multiple recipients of list ULTRASOUND" Subject: RE:
EFW accuracy Message-ID: Content-class: urn:content-classes:message
MIME-Version: 1.0 Content-Type: multipart/alternative;
boundary="----_=_NextPart_001_01C8BB50.85285723" This is a multi-part message
in MIME format. ------_=_NextPart_001_01C8BB50.85285723 Content-Type:
text/plain; charset=us-ascii Content-Transfer-Encoding: quoted-printable I
suspect the reason sonographic measurements are considered so questionable is
that there are so many people using sonography who do not have rigorous
training and do not practice precise methods. Many seem to think precise
measurement methods are not necessary because "ultra!<BR>sound" is<BR>not
considered accurate, a sort of self-fulfilling problem. In a lawsuit in
which I was an expert witness, a case very similar the one under current
discussion, the sonographer has attended an unaccredited, = short course of
study, was not credentialed by the ARDMS, and was on-call by herself. It was
obvious she had measured the abdominal circumference at = the ribs and spine
in back, completely excluding the skin, baby fat, and muscles in back. The
vaginal delivery also ended up with dystocia and neurological damage in the
neonate. It is my opinion that sonography, in the hands of a skilled
sonographer, is much more accurate than it is given credit for being. But many
simply do not take the time and/or do not have the understanding and skill to
use it effectively. I would like to see how the measurements in the
case under current = discussion were actually made. We also need to be moving
to volumetric measurements, the fetus does not liv!<BR>e in "Fla<BR>t Land"...
and the head molds considerably, especially in the vertical axis due to the
sutures and fontanels. Terry J. DuBose, M.S., RDMS, FSDMS, FAIUM Associate
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 or 501-686-5948
DuBoseTerryJ@UAMS.edu http://www.uams.edu/chrp/sonography/
http://www.obgyn.net/us/panel/panel.htm http://www.io.com/~dubose/
---------------------------------------------------------------
[mailto:ultrasound@obgyn.net] On Behalf Of Dave Berck Sent: Tuesday, May=
---------------------------------------------------------------
20,=20
---------------------------------------------------------------
2008 4:46 PM To: Multiple recipients of list ULTRASOUND Subject: Re: EFW
accuracy true David J. Berck, MD, MPH ----- Original Message
---- From: "DoctorJoe@aol.com" To: Multiple recipients of list ULTRASOUND
Sent: Tuesday, May 20, 2008 4:39:17 PM Subjec!<BR>t: Re: EF<BR>W accuracy In a
message dated 5/20/08 1:57:45 PM, djberck@yahoo.com writes: comparison was
made between U/S EFW, Leopold's , and Maternal estimates of EFW. The maternal
estimates were the most accurate. Only mother's who had already had one
(http://food.aol.com/dinner-tonight?NCID=aolfod00030000000001)
Confidentiality Notice: This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidentia l= and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message. ------_=_NextPart_001_01C8BB50.85285723 Content-Type: text/html;
charset=us-ascii Content-Transfer-Encoding: quoted-printable !<BR><BR>I
suspect the reason sonographic = measurements are considered so questionable
is that there are so many people using sonography who do not have rigorous
training and do not practice precise methods. Many seem to think precise
measurement methods are not necessary because “ultrasound” is not considered
accurate, a = sort of self-fulfilling problem. <BR><BR>In a lawsuit in which I
was an expert witness, a case very similar the one under current discussion,
the = sonographer has attended an unaccredited, short course of study, was not
credentialed by the ARDMS, and was on-call by herself. It was obvious she had
measured the abdominal circumference at the ribs and spine in back, completely excluding the skin, baby fat, and muscles in back. The vaginal delivery also ended up with dystocia and neurological damage in the neonate. <BR><BR>It is my opinion that sonography, in = the hands of a skilled
sonographer, is much more accurate than it is given = credit for being. But
many simply do not take the time and/or do not= = have the understanding and
skill to use it effectively. = <BR><BR>I would like to see how the ==
measurements in the case under current discussion were actually made. ==
We
also need to be moving to volumetric measurements, the fetus does not live in “Flat Land” and the head molds considerably, especially in the vertical
axis due to the= = sutures and fontanels.<BR><BR>Terry J. DuBose, M.S., RDMS,
FSDMS, = FAIUM<BR><BR>Associate Professor & Director<BR>Diagnostic
Medical Sonography Program<BR>University= of Arkansas for Medical Sciences, CHRP<BR>4301 West Markham = St. Mail Slot #563<BR>Little Rock, ==
Arkansas,
72205 USA<BR>501-686-6510 or
501-686-5948<BR>DuBoseTerryJ@UAMS.edu<BR>http://www.uams.edu/chrp/sono==
graphy/<BR>http://www.obgyn.net/us/pa nel/panel.htm<BR>http://www.io.com/~dubose/<BR>--------------------------- ultrasound@obgyn.net [mailto:ultrasound@obgyn.net] On Behalf Of Dave=20
nel/panel.htm<BR>http://www.io.com/~dubose/<BR>--------------------------- Berck<BR>Sent: Tuesday, May 20, 2008 =3D 4:46 PM<BR>To: Multiple=
nel/panel.htm<BR>http://www.io.com/~dubose/<BR>--------------------------- recipients of list ULTRASOUND<BR>Subject: Re: EFW = accuracy<BR><BR><BR>true
<BR><BR><BR><BR>David J. Berck, MD, MPH = <BR><BR>----- Original Message
----<BR>From: "DoctorJoe@aol.com" <BR>To: Multiple recipients of list
ULTRASOUND = <BR>Sent: Tuesday, May 20, 2008 4:39:17 PM<BR>Subject: Re: EFW
accuracy<BR><BR><BR>In a message dated 5/20/08 1:57:45 PM, djberck@yahoo.com
writes:<BR><BR><BR><BR><BR>comparison was made between U/S EFW, Leopold's ,
and Maternal estimates of EFW. The maternal estimates were the most accurate.<BR><BR><BR>Only mother's who had already had one pregnancy already
(I believe).<BR><BR>Joe P.<BR><BR><BR><BR><BR>**************<BR>Wondering=20
what's for Dinner Tonight=3D3F Get new twists on family favorites a=3D t=
= AOL
Food.<BR>(http://food.aol.com/dinner-tonight?NCID=aolfod0003000 0000001) <BR><BR><BR><BR><BR>Confidentiality Notice: This e-mail message,
including any= = attachments, is for the sole use of the intended recipient(s)
and may = contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not ==
the
intended recipient, please contact the sender by reply e-mail = and destroy
all copies of the original message.
<BR>------_=_NextPart_001_01C8BB50.85285723-- ------------------------------
Date: Wed, 21 May 2008 14:16:17 -0700 (PDT) From: Dave Berck To:=20
------------------------------
ultrasound@obgyn.net Subject: RE: EFW accuracy Message-ID: MIME-Version:=
------------------------------
1.0
Content-Type: text/html; charset=utf-8 Content-Transfer-Encoding:
quoted-printable I agree. This applies to other areas of u/s also. 1st tri screening works presumably because standards are adhered to. But in ==
this
case, had the birthweight been known exactly, most OBs would still all==
ow a
vaginal delivery, in which case this is simply a case of an unavoidabl==
e
shoulder dystocia.<BR><BR><BR>David J. Berck, MD, MPH<BR><BR>--- On Wed,
5/21/08, DuBose, T= erry wrote:<BR><BR>From: DuBose, Terry <BR>==
Subject: RE:
EFW accuracy<BR>To: "Multiple recipients of list ULTRASOUND"
ultrasound@mail.obgyn.net><BR>Date: Wednesday, May 21, 2008, 10:42 AM=
<BR><BR>I suspect the reason= sonographic measurements are considered so
questionable is that there are = so many people using sonography who do not
have rigorous training and do no= t practice precise methods. Many seem to
think precise measurem= ent methods are not necessary because
“ultrasound†is not c= onsidered accurate, a sort of
self-fulfilling problem. <BR>= <BR>In a lawsuit in whic= h I was an expert
witness, a case very similar the one under current discus= sion, the
sonographer has attended an unaccredited, short course of study, = was not
credentialed by the ARDMS, and was on-call by herself. = It was obvious she
had measured the abdominal circumference at the ribs and= spine in back,
completely excluding the skin, baby fat, and muscles in bac= k. The vaginal
delivery also ended up with dystocia and neurolo= gical damage in the neonate.
<BR>= <BR>It is my opinion tha= t sonography, in the hands of a skilled
sonographer, is much more accurate = than it is given credit for being. But
many simply do not take = the time and/or do not have the understanding and
skill to use it effective= ly. <BR>= <BR>I would like to see = how the
measurements in the case under current discussion were actually mad= e. We
also need to be moving to volumetric measurements, = the fetus does not live
in “ Flat Land â€â€¦ and the h==
ead molds considerably,
especially in the vertical axis due to the sutures = and fontanels.<BR>=
<BR>Terry J. DuBose, = M.S., RDMS, FSDMS, FAIUM<BR><BR>Associate Professor
& Director<BR>Diagn= ostic Medical Sonography Program<BR>University of
Arkansas for Medical Scie= nces, CHRP<BR>4301 West Markham St. Mail Slot
#563<BR>Little Rock , Arkansa= s , 72205 USA<BR>501-686-6510 or
501-686-5948<BR>DuBoseTerryJ@UAMS.edu<BR>http://www.uams.edu/chrp/sonography/<BR>http://www.obgyn.ne t/us/panel/panel.htm<BR>http://www.io.com/~dubose/<BR>----------------==
=20
t/us/panel/panel.htm<BR>http://www.io.com/~dubose/<BR>----------------==
-----------------------------------------------<BR><BR><BR>From:=20
t/us/panel/panel.htm<BR>http://www.io.com/~dubose/<BR>----------------==
ultrasound@obgyn.net [mailto:ultrasound@= obgyn.net] On Behalf Of Dav= e
Berck<BR>Sent: Tuesday, M= ay 20, 2008 4:46 PM<BR>To: = Multiple recipients of
list ULTRASOUND<BR>Subject: Re: EFW accuracy<BR><BR><BR>true <BR><BR><BR>=
> <BR>David J. Berck, MD, MPH <BR><BR>----- Original Message ----From:
"DoctorJoe@aol.com" <BR>To: Multiple reci= pients of list ULTRASOUND <BR>Sent:
Tuesda= y, May 20, 2008 4:39:17 PM<BR>Subject: Re: EFW accuracy<BR><BR><BR>In
a message = dated 5/20/08 1:57:45 PM, djberck@yahoo.com
writes:<BR><BR><BR><BR><BR>comparison was made between U/S EFW, Leopold= 's ,
and Maternal estimates of EFW. The maternal estimates were the most ac==
curate.<BR><BR><BR>Only mother's who had already had on= e pregnancy already
(I believe).<BR><BR>Joe P.<BR><BR><BR><BR>**************<BR>Wondering what's=20
for Dinner Tonight? Get new twists =3D on family favorites at AOL=20
Food.<BR>(http://= food.aol.com/dinner-tonight?NCID=aolfod00030000000001) <BR><BR><BR><BR><BR>Confidentiality Notice: This e-mail message, including any
attachme= nts, is for the sole use of the intended recipient(s) and may
contain confi= dential and privileged information. Any unauthorized review,
use, disclosu= re or distribution is prohibited. If you are not the intended
recipient, p= lease contact the sender by reply e-mail and destroy all copies
of the orig= inal message. <BR><BR>------------------------------ End of=20
of the orig= inal message. <BR><BR>------------------------------ ULTRASOUND Digest 2786 *****************************=20
of the orig= inal message. <BR><BR>------------------------------<o:p></o:p></P></BLOCKQUOTE>
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