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Re: Anomaly scan, Serum testing, Down SyndromeFrom: DuBose, Terry (DuboseTerryJ@uams.edu)Mon Jul 14 11:46:54 2008
Well... depends on the author. Callen's new textbook (5th edition) shows the BPD to be from 20 to 23 mm during the 13th week (13.2-13.8 weeks). My own measurements show the BPD to be 23 mm at 13 weeks, based upon several thousands of cases. We really don't have any precise measurements, and many refer to any fetus between 13.0 and 13.9 weeks, "as 13 weeks". This is the reason I have always advocated estimating fetal age to the 1/10 of a week, rather than just weeks or even weeks + days... it is easier to average the multiple fetal parameter ages after Hadlock's method. This really does not tell us the precise measurement, "I have a 33yr old gravida2, with 13 weeks pregnancy, scan done today shows mild ventriculomegaly...." It may be that because at 13 weeks the choroid plexus and lateral ventricles appear to fill the cerebral hemispheres that the "mild ventriculomegaly" call was made. Without measurements we can't argue the point. But I do believe that by the start of the 1st trimester, the lateral ventricular atria has reached 7-10 mm and remains that size as the head and cerebrum enlarges around them. 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/ --------------------------------------------------------------- P Please consider the environment before printing this e-mail --------------------------------------------------------------- --------------------------------------------------------------- -----Original Message----- From: ultrasound@obgyn.net [mailto:ultrasound@obgyn.net] On Behalf Of James Smeltzer Sent: Friday, July 11, 2008 5:44 PM To: Multiple recipients of list ULTRASOUND Subject: Re: Anomaly scan, Serum testing, Down Syndrome andLateralventricles Just a comment that the normal 13 week BPD is 20. Even though the LVs are close to 10, as every cell in the brain must come from the wall of the tube, and few cells have been made yet, the whole cannot be greater (or less) than the sum of its parts. JSS
>>> "DuBose, Terry" <DuboseTerryJ@uams.edu> 7/11/2008 6:06 PM >>> I can't find a specific image with measurements at 13 weeks, but in Fetal Sonography, p. 431 there is a sonogram that shows the choroid plexus and lateral ventricles to be at 10 mm in width (the scale is on the image). Also, I found an image of a 13 week fetal head in Callen's latest edition (5th edition, p. 364) that show the structures and describe them as ", the intercrainal anatomy is dominated by the prominent choroid plexuses of the lateral ventricles." I don't know when the width of the lateral ventricles actually reaches 7-10 mm, but it is during the end of the 1st trimester. The head then grows larger around the ventricles, which make them appear to become smaller, but they remain about <10mm in width throughout the rest of the gestation. 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/ --------------------------------------------------------------- P Please consider the environment before printing this e-mail --------------------------------------------------------------- --------------------------------------------------------------- -----Original Message----- From: ultrasound@obgyn.net [mailto:ultrasound@obgyn.net] On Behalf Of jworrall@alaska.net Sent: Thursday, July 10, 2008 12:52 PM To: Multiple recipients of list ULTRASOUND Subject: Re: Anomaly scan, Serum testing, Down Syndrome and Lateralventricles Thanks Dr. Smeltzer. Yes, I realize now that an atrium of 10-15 mm at 13 weeks would mean the fetal head had to be enormous. Allen
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