Re: OB: AFP/multiple marker dating

From: Garry E. Siegel, M.D. (garrys@mindspring.com)
Tue May 4 21:54:59 2004


Thanks to all, and I am going to talk to an MFM tomorrow and see if he has insight. I am just too tired and lazy to try to search for an article.

Ron (I think)I disagree about another ultrasound for dating. The first trimester one is more accurate.

I told the CNM she can't have it both ways; if she used the LMP and ultrasound ot assign the EDC of 10/7 based on the LMP (which is what we all think is right), then she can't simply change the EDC assignment to normalize the test. However, if there is evidence that simply using the first trimester scan's EDC is preferrred, then that is another story and we'll have to revamp our EDC calculations.

Garry

At Tue, 4 May 2004, Anna Meenan, MD wrote: >
>I would use the menstrual EDC (assuming she has a 28-day cycle, of
>course), but if she is a CNM, she knows all this stuff and should know
>the risk. It's her choice, I suppose.
>
>--
> Anna Meenan, MD
>
>At Tue, 4 May 2004, Garry E. Siegel, M.D. wrote:
>>
>>OK, a quick curbside until I can research further. The patient is a CNM
>>one, so this kind of fell into my lap late today.
>>
>>20 YO P0 has an AFP triscreen done
>>
>>LMP makes her EDC 10/7/04
>>7 week scan makes her EDC 10/10/04
>>
>>To me, that is excellent correlation, and the EDC we tell the patient is
>>10/7/04.
>>
>>10/7/04 is the EDC used for the AFP.
>>
>>The report comes back--increased Down risk, 1/230 or whatever.
>>
>>The CNM has the lab plug in 10/10 for the EDC, and the recalucation is
>>"normal risk" of 1/350.
>>
>>So. . .
>>
>>Which EDC should have been used initially?
>>
>>If it is the period EDC, what do the results mean?
>>
>>What's a mother to do???
>>
>>Garry
>>
>>--
>>Garry E. Siegel, M.D.
>>Private Practice
>>Roswell, GA
>>

--
Garry E. Siegel, M.D.
Private Practice
Roswell, GA




use when must restrict search to only the ob-gyn-l forum...
Enter search keywords:
Returns per screen: Require all keywords:

Return to  OB-GYN-L Mail a New Message to the Forum: ob-gyn-l@obgyn.net
Forum Administrator: geffrey.klein@obgyn.net
Report Technical Problems: webmaster@obgyn.net
Last Updated: Mon Nov 2 04:55:18 2009

The American Medical Association is no longer designating CME hours for AMA Category II CME credit. However, physicians themselves may self designate learning activities as Category II CME credit hours if they feel it is of sufficient educational merit and meets the formal definitions of continuing medical education. OBGYN.net believes these interaction in this forum meets these criteria. For further information see the AMA web site.