Re: update on superfetation vs severe IUGR
From: art fougner, md (evsono@pipeline.com)
Wed Mar 7 06:49:22 2001
it appears a consultant is about to be stripped of rank after this
"Bitter Creek."
art
At Wed, 7 Mar 2001, Braun, R. Daniel wrote:
>
>Horses, not zebras. Severe malnutritional IUGR will be symmetric after a
>certain length of time, when it gets so bad that it actually overcomes the
>protective shunts that usually spare the head.
>
>Dan
>
>-----Original Message-----
>From: mks@sierra.net [mailto:mks@sierra.net]
>Sent: Tuesday, March 06, 2001 6:06 PM
>To: Multiple recipients of list OB-GYN-L
>Subject: update on superfetation vs severe IUGR
>
>Well, my 41 yo G1 29 wweks by my US chronic hypertensive developed
>superimposed preeclampsia, so I shipped her to the MFM and the tertiary
>care center. The MFM, who kept saying she didn't have IUGR because his
>scan showed symmetric measurements, a grade I placenta and normal fluid
>and she was just due 4 weeks later than I said, just called to tell me
>he delivered the baby -- 29 weeks with severe IUGR (birthweight was
>around 600 gms) and an infarcted grade III placenta.
>
>He still says it is a wierd case because the baby seemed to be growing
>appropriately for the last few weeks, after an apparant period of almost
>no growth in the early - mid second trimester.
>
>Don't know how the baby will do ultimately (they have had a hard time
>getting lines in because hte kid is so tiny) and I still don't know if
>they are going to do chromosomes on hte baby -- all the MFM said when I
>asked if the baby looked normal, was that it was hte tiniest runt he'd
>seen.
>
>Although I would have preferred a perfectly normal outcome for this
>patient, I sure feel vindicated as I argued with the MFM all along that
>this was severe IUGR.
>
>Kelly
--
art fougner, md
A series of 1000 cases begins with but a single anecdote.
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