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Re: Superfetation or severe IUGR?? From: Efrain Ramirez (eramirez@icepr.com) Sat Feb 24 20:53:20 2001 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Garry Siegel: "Re: Superfetation or severe IUGR??" Previous message: Efrain Ramirez: "Re: US docs only. Telephone consults" In reply to: M. Kelly Shanahan, MD: "Superfetation or severe IUGR??" Next in thread: Garry Siegel: "Re: Superfetation or severe IUGR??" Reply: Garry Siegel: "Re: Superfetation or severe IUGR??" Superfetation possible? - chromosal anomaly likely - agree with Joe - genetic amnio for managment - not for abortion - Who did the first TVS -- ?? You -- I have seen CRL way out -- including the yolk sac be careful! but must agree tha bwe most probably are dealing with an abnormal fetus - whatever that means. At Sat, 24 Feb 2001, M. Kelly Shanahan, MD wrote: > >You tell me what you think: > >41 yo G1 (LMP 8/10 EDC 5/17) with essential hypertension has an abnormal >triple screen (risks of TS 21 >1:10). Pt referred for genetic >counseling under California's system and gets scanned -- by that 17 week >scan the MFM redates her with an EDC of 6/14 and tells her we were off >on her dates. > >That's well and good EXCEPT, she had first trimester spotting and had a >TVUS 9/22 showing a 6 wk 3 day fetus with a heartbeat, another scan 2 >wks later showing an 8 wk 3 day fetus and a third scan at 15.3 weeks >where measurements equaled 14.5 weeks. I call the MFM, who hadn't >reviewed the records sent with the patient and he aggrees there probably >really is a problem. Pt refuses genetic testing as she would not >terminate under any circumstances. > >Pt continues to be significantly S<D and has serial US showing about a >4-5 week discrepancy with her dates and early US. > >Sent for a second MFM consult with a different MFM (MFM#1 just does >genetic counseling). This MFM scans her, gets an EDC of 6/20 and says >there is no IUGR, just erroneous dates. He does review all hte data and >can't explain how we saw a 6 week fetus on 9/22, which is a couple of >days before the estimated date of conception according to his scan. >"Maybe she lost the first one and just got pregnant again" is his >explantation". > >I know superfetation occurs in horses, but humans? And even if this is >superfetation, how can you explain seeing a fetus at 6 wks, 8 wk and 15 >wks, then it completely disappearing only to be replaced by a second >baby, never seen before that is 4 weeks younger?? > >Kelly >Kelly Shanahan, MD, FACOG >S. Lake Tahoe, CA -- "Life is neither the notes nor the silence between the notes, but the music that arises out of sound and silence felt as a living whole. Stop choosing...between chaos and order, and live at the boundary between them, where rest and action move together..." David Whyte Next message: Garry Siegel: "Re: Superfetation or severe IUGR??" Previous message: Efrain Ramirez: "Re: US docs only. Telephone consults" In reply to: M. Kelly Shanahan, MD: "Superfetation or severe IUGR??" Next in thread: Garry Siegel: "Re: Superfetation or severe IUGR??" Reply: Garry Siegel: "Re: Superfetation or severe IUGR??"

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