Re: OB: Advanced Maternal Age
From: art fougner, md (evsono@pipeline.com)
Tue Dec 26 10:55:20 2000
"It ain't over til it's over."
Lawrence Peter Berra
art
At Tue, 26 Dec 2000, Dean Huffman wrote:
>
>About a year ago I had a consult of a patient, age 35, who was an
>ultrasound technician. So was her husband. All four of us, the
>patient, her husband, my ultrasonographer, and myself, all thought the
>fetus appeared normal. She had not done a triple screen. After the
>ususal discussion, including the predicted risks of Downs based on age
>and a normal appearing ultrasund, she decided to do the amniocetnesis
>anyway.
>
>It came back 47 +21.
>
>A week ago, I had another patient with a normal appearing ultrasound and
>only minimally increased risk of Downs on triple screen (about 1:250).
>She also requested amniocentesis and, again, a 47 +21.
>
>Short of amniocentesis (possibly maternal blood testing for fetal
>chromosomes in the future), the patient has to realize that she is
>playing the numbers.
>
>--
>Dean Huffman
>
>- - - -
>
>At Sun, 17 Dec 2000, Efrain Ramirez wrote:
>>
>>Bit skeptical about it -- recently had a 28? y/o negative --I mean
>>really negative screen for DS (odds in the thousands)-- had DS - I still
>>believe that it is not sensitive enough - even with the inhibin stuff.
>>
>>If you have a MFM -- REALLY good at U/S you can cut in half the odds -
>>but - still I am not convinced.I might change my mind --though.
>>
>>At Sat, 16 Dec 2000, Geffrey Klein, MD wrote:
>>>
>>>Any thoughts on this Green Journal Article?
>>>
>>>Efficacy of Screening for Fetal Down's Syndrome in the US from 1974
>>>to 1997. Egan etal Obstet Gynecol 2000;96:979-85
>>>
>>>Essentially they are saying that the idea of offering amnio to women
>>>who will 35 or older at delivery is no longer valid and that triple
>>>screen should be used instead..
>>>
>>>--
>>>_______________________
>>>Geffrey H. Klein, MD
>>>_______________________
>>>_______________________
>>>_______________________
>>>geffrey.klein@obgyn.net
>>>200 Medical Center Blvd Suite 103
>>>Webster, TX 77598
>>>(281) 332 6723
>>>
>>>http://www.geffreyklein.com
>>>
>>--
>>"Do not take life too seriously. You will never get out of it alive."
>>
>>Marianne Williamson
>>
--
art fougner, md
A series of 1000 cases begins with but a single anecdote.
