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Re: Opinions please!From: Luis Sanchez-Ramos, MD (sanchez-ramos@worldnet.att.net)Sun Feb 27 17:57:06 2000
At Sun, 27 Feb 2000, Braun, R. Daniel wrote: >> By Jove, I think there is a real consensus Here<< We also agreed that the fetus would probably be better off in the NICU than in the hostile environment of the amniotic cavity. However, we were concerned with the possibility that this fetus may have had a lethal anomaly. We were unable to delineate the anatomy due to the severe oligohydramnios. We were able to see dilated loops of bowel suggesting perhaps imperforate anus. There was little evidence of IUGR by sonographic parameters i.e: transcerebellar diameter(thought not to be affected by IUGR)was consistent with a 27 week's gestation. Similarly, FL/AC ratio was consistent with no evidence of assymetrical IUGR. The patient had a BP of 140/90 mmHg on a couple of occasions and 24hr urine collection revealed significant proteinuria (500 mg)and marked hypocalciuria (46mg/vol). Repeat BPP today was 6/10 but the 2 points for AFV were due to the small amount of saline infused during the attempted transabdominal amnioinfusion. She continued to show moderate to severe variable decelerations (intermittently). This afternoon the patient was delivered by cesarean (frank breech)and the neonate weighed 980 gm and had Apgar scores of 7/7 at 1 and 5 minutes respectively. The neonate of course was admitted to the NICU. I haven't heard of any anomalies but it appeared to be normal. I want to thank everyone for their opinion(s).
-- Luis Sanchez-Ramos, MD
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