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Re: Fetal AnomalitiesFrom: art fougner, md (evsono@pipeline.com)Sun Apr 27 18:09:49 2008
... We recommend that when a CPC or an EIF is the only detected abnormality (ie, it is an isolated marker on a second- or third-trimester sonogram that meets the most recently adopted AIUM performance guidelines) that the sonographic report emphasize that, as an isolated finding in a patient otherwise considered at low risk for fetal aneuploidy, a CPC or an EIF is not considered clinically significant and does not change her from low- to high-risk status (see below). The following statement and recommendations meet these needs and may be used either as an example or a template: 1. A (CPC or EIF) is identified. Although this finding has been reported in association with fetal chromosome abnormalities, no other major or minor anomalies were identified in this fetus. In the absence of other risk factors, this is considered a normal variant, and no further evaluation is recommended. 2. The attending obstetrician is notified so that the risk status of the patient can be ascertained. (In many clinical situations, the attending obstetrician may be the individual who performed the sonography and recognized the CPC or EIF. As well, the sonologist may be a maternal-fetal medicine consultant who could then make the final determination regarding the patient’s risk status.) The AIUM guidelines should be strictly followed. Furthermore, when an EIF is identified, it is necessary to evaluate for other sonographic markers of trisomy 21, such as nuchal thickness. Similarly, when a CPC is identified, it is necessary to exclude other sonographic markers of trisomy 18, such as "clenched" hands. These additional efforts will help add to the certainty that the EIF or CPC is a normal variant in a low-risk woman... Choroid Plexus Cyst and Echogenic Intracardiac Focus in Women at Low Risk for Chromosomal Anomalies Roy A. Filly, MD1, Beryl R. Benacerraf, MD2, David A. Nyberg, MD3 and John C. Hobbins, MD J Ultrasound Med 23:447-449 • 0278-4297 Read the whole thing. Additionally, informing the Mom to be of the controversy surrounding CPC as an isolated finding would also be prudent. Art
At Sat, 26 Apr 2008, ri nag wrote:
>
-- art fougner, md "May The Wings of Liberty Never Lose a Feather." - Jack Burton
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