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Re: F/U 15 Week Echo Twin A ,NT4.3 ;Twin B NT 1.6, nl chromo From: art fougner, md (evsono@pipeline.com) Fri May 30 07:15:05 2003 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: art fougner, md: "Re: IUFD @ 35 weeks" Previous message: Griffiths Malcolm: "Re: IUFD @ 35 weeks" In reply to: Charlie Chambers: "Re: F/U 15 Week Echo Twin A ,NT4.3 ;Twin B NT 1.6, nl chromo" Next in thread: Patricia Sabb: "Re: F/U 15 Week Echo Twin A ,NT4.3 ;Twin B NT 1.6, nl chromo" NT is a screening test, NOT a diagnostic test. The majority of fetuses with abnormal nuchals will have a normal outcome. That being said, in this case, there are a laundry list of syndromes associated with abnormal nuchals and normal karyotype. The nl fetal echo at 14/15 wks is reassuring but not definitive. would therefore repeat the ultrasound and echo at 20 -22 weeks. The different genders should make twin-twin transfusion highly unlikely as a cause for abnormal nuchal here. Fetal echos can have false negatives - especially the small VSD's commonly missed. These, however, are usually of small import in the newborn nursery. When it comes to prenatal diagnosis, the Lawrence Peter Berra caveat applies - "It ain't over til it's over." Good luck and i hope this helps. art At Thu, 29 May 2003, Charlie Chambers wrote: > >Is this question in retrospect, i.e. that is how the karyotypes are >known or was amnio done? Nuchal translucency has been a marker for risk >for aneuploidy, therefore, if karyotype is normal than forget about the >NT. With that much discrepancy, I wonder how well the NT was performed? >Was this from a center with much experience? Real easy to accidentally >measure distance to the amnion. Too my knowledge suggesting adverse >outcomes with increased NT and normal karyotype. Anyone, please correct >me if I'm, wrong. NT is still a screening tool, and probably more >effective to suggest decreased risk. As a screening tool, normal >karyotype with abnormal NT is not unheard of. >On Thursday, May 29, 2003, at 09:08 AM, Patricia Sabb wrote: > >> 35 yo physician with lower(closer to cervix) Twin A 46XX, NT 4.3; Twin >> B >> 46XY, NT 1.6. Echo at 14 wk 6 day showed no obvious cardiac >> abnormalities. >> >> Risk of abnormality not detectable on US prenatally? Is it really 10%? >> >> If selective reduction of lower twin with increased nuchal, risk to >> other twin? >> >> Maternal factors influence NT? Since twins with discordant NT, more >> likely to signify abnormality? >> >> How can you explain increased NT at 11-14 wk with a subsequent normal >> outcome? Why was it elevated originally? >> >> Patient is naturally pessimistic (side effect of being a doctor and >> seeing the worst) and is having a hard time deciding next course of >> action. >> >> Thank you for your help. >> >> -- >> Patricia Sabb, MD >> >************************************************************************ >* > >-- >************************************************************************ >Charlie Chambers >Hood River, OR >cchamber@alumni.rice.edu > >"No matter where you go... > there you are." >Dr. Buckaroo Banzai >************************************************************************ > >************************************************************************ > -- art fougner, md ich bin ein New Yorker Next message: art fougner, md: "Re: IUFD @ 35 weeks" Previous message: Griffiths Malcolm: "Re: IUFD @ 35 weeks" In reply to: Charlie Chambers: "Re: F/U 15 Week Echo Twin A ,NT4.3 ;Twin B NT 1.6, nl chromo" Next in thread: Patricia Sabb: "Re: F/U 15 Week Echo Twin A ,NT4.3 ;Twin B NT 1.6, nl chromo"

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