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Re: Ultrasound screening in advanced maternal age.From: art fougner, md (evsono@pipeline.com)Mon Nov 3 09:52:08 1997
At Sat, 1 Nov 1997, amendel@juno.com wrote: > >It seems to me that the amniocentesis is valuable in identifying >problems. It does not however solve those problems. If knowing a fetus >has a trisomy either allows the patients to prepare themselves for the >birth or gives them time to arrange termination than the testing is >appropriate. If gaining the knowledge is not of benefit to them than I >don't think any further referrals is necessary. It's the old >adage....How does the test change your management. > >Hope everyone had fun Trick or Treating. > >Aaron Mendel MD >Fallon Clinic >Worcester MA 01520 hi amnio or ultrasound may not change management for some women. however, consider this scenario. amnio reveals trisomy 21. because of the high incidence of congenital heart disease, fetal echo is performed revealing complex disease necessitaing transfer to a tertiary center. in this case, the amnio obviously impacted on the follow-up care. now consider the second scenario, trisomy 18. early in the third trimester severe iugr is suspected and conservative management is elected due to the abysmal outcome with this karyotype. multiple biophysical tests as well as hospitalization are thus avoided.finally, it has been my experience that more than a few couples have changed their minds re: management when confronted with abnormal karyotypes/complex congenital malformations.
-- art fougner, md SonoScan/Genetic Sciences forest hills, ny evsono@pipeline.com
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