-VISIT OUR OTHER FORUMS- OB-GYN-L Ultrasound Ultrasound History Fibroid Forum Physicians-in-Training Tech Talk OBSTET-L (portuguese) OBGIN-L (spanish) Nursing

Re: discrepant twins From: T Dubose (tjdubose@chrp.uams.edu) Tue Jul 2 08:38:38 1996 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: mdjacob@techunix.technion.ac.il: "Re: 20 weeks with PPROM + previa" Previous message: Mickey Gillmor-Kahn, CNM: "Re: physician owned medical insurance companies" Maybe in reply to: STEWART PRINGLE: "discrepant twins" Next in thread: Ronald Helm: "Re: discrepant twins" Discrepant growth is mentioned from time to time, but little is discussed about the underlying causes. Unfortunately, no one on this list ventured an answer to my questions as to: " Is it possible for the blastocyst to split into unequal cell masses and result in discrepant growth? This might explain the difference in size in the first half of the pregnancy. Or, how soon could a mild degree of twin-to-twin transfusion start effecting the pregnancy without causing sever problems, just a 25% difference in size?" I thought for sure someone on this list would venture an opinion. May be no one really knows about these very early events, yet. As far as your case of two weeks discrepant growth in the 1st trimester, I would be interested as to when in the 1st trimester the sonograms were done? Was the dating by Crown-Rump Length (CRL)? Also, if it was before the 9th week was an embryonic heart rate (EHR) measured by M-mode? In our case the EHR correlated with the CRL; i.e. at 6 & 7 weeks the larger twin embryo had the faster EHR and both correlated as normal by our EHR-AGE regression. For more detail on this regression please see Chapter 12, Heart Rate in FETAL SONOGRAPHY, W. B. Saunders, 1996. Also, Chapter 7, Size/Age Analysis discusses discrepant growth under the subtitle "Tale of Two Babies". If you would be willing to Email me the CRL and EHR on the two embryos, I would like to analyze them using the regression. If the EHR correlates with the CRL, then I would suspect that the sonographic measurements were correct, and a true discrepancy existed. Of course, since the smaller twin died, that may indicate an anomaly which in turn may have affected the EHR. Peace, Terry J. DuBose, M.S., RDMS; Program Director, Diagnostic Medical Sonography University of Arkansas for Medical Sciences, College of Health Related Professions tjdubose@chrp.uams.edu http://www.io.com/~dubose/ Now is the time for all good folks to come to the aid of the Earth. -- ---------- From: STEWART PRINGLE To: Multiple recipients of list Subject: discrepant twins Date: Monday, July 01, 1996 9:26PM I read with interest the account of Terry's case. Recently we had twins with a 2 week size difference noted on scan in the first trimester. The smaller twin was live and grew for a few weeks but died in the 2nd trimester. I htink the woman is still carrying the survivor. I'd never come across this before and assumed for a while that it was an U/S error. Is there much written about this? -- Stewart Pringle Career Registrar Stirling Royal Infimary Stirling, UK 100724.2333@compuserve.com Next message: mdjacob@techunix.technion.ac.il: "Re: 20 weeks with PPROM + previa" Previous message: Mickey Gillmor-Kahn, CNM: "Re: physician owned medical insurance companies" Maybe in reply to: STEWART PRINGLE: "discrepant twins" Next in thread: Ronald Helm: "Re: discrepant twins"

Return to

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 05:18:59 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.