|
|
 |
 |
 |
|
|
|||
|
||||
|
||||
Re: Difficult twins at 32 6/7 weeksFrom: art fougner, md (evsono@pipeline.com)Thu Mar 5 07:24:35 1998
At Wed, 4 Mar 1998, ATB28 wrote: > >In a message dated 98-03-04 12:04:31 EST, evsono@pipeline.com writes: > ><< At Tue, 3 Mar 1998, Bruce Pielet, MD wrote: > > Mea Maxima Culpa! sorry. in that case your choices are: 1- Deliver - at a tertiary hospital at this gestational age and size should have a more than reasonable expectation of good outcome. 2- admit for intensive surveillance. Is the fetus with the abnormal doppler structurally normal? consider PUBS for both karyotype ( abnormal doppler conveys increased risk for aneuploidy) and pO2. along these lines, take a look at the venous doppler waveforms of the small twin, specifically the IVC and the ductus venosus. recent evidence suggests that a nl venous waveform is reassuring and is consistent with a lack of acidosis. also, what does the MCA waveform look like. if this is nl ( unless the fetus has a flat NST), the fetus is likely to have a reasonable pO2. in the face of abnormal arterial AND venous waveforms in an otherwise normal fetus, would deliver. i hope this is helpful and i do apologize if my previous comment seemed glib. i wish you and your patient the very best of luck. art
-- art fougner, md SonoScan/Genetic Sciences forest hills, ny evsono@pipeline.com
|
|
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: Wed Dec 2 05:23:40 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.