Re: F/U 15 Week Echo Twin A ,NT4.3 ;Twin B NT 1.6, nl chromo
From: Patricia Sabb (pcsabb@wisc.edu)
Fri May 30 08:46:58 2003
Yes, CVS done at 11 wk 5 days. Yes, reputable center with excellent and
experienced ultrasound tech, perinatologist there also. The discrepancy
between the twin NTs is what makes the patient suspect something must be
wrong with Twin A.
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
>************************************************************************
>
>************************************************************************
>
--
Patricia Sabb
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