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Re: To terminate or not to terminateFrom: Ahmed Talaat (a.s.talaat@mds.qmw.ac.uk)Wed Apr 1 03:09:54 1998
At Thu, 19 Mar 1998, art fougner, md wrote: > >this sounds like a case for the ultrasound forum as well. if possible, >contact terry re: posting representative pics for opinions. > >this fetus with effusions and oligo seems atypical for a viral origin >since those generally result in polyhydramnios. ditto for fetal anemia >with hypoproteinemia/high output failure. would urge rapid karyotyping >via PUBS. however, it also seems as if this fetus may be in extremis >with the new onset of hydrops. do you have any doppler data? also, what >does the FHR tracing/ cardiotocogram show? > >good luck. > >art > >At Thu, 19 Mar 1998, Dr. Omar Farag MD. wrote: >> >>A 43 y primigravida, with gestational diabetic, insulin dependent, in >>now in the 27th week of her pregnancy. Ultrasonography done three weeks >>ago revealed oligohydramnios. When it was repeated this week, it became >>clear that there is also fetal ascites, and moderate degree of >>hydronephrosis on one side, with lesser degree on the other side, >>together with some pericardial effusion, and scrotal edema. No other >>anomalies were detected (until now). Would you terminate this precious >>pregnancy, or what? >> >>-- >>Dr. Omar Farag MD. >>Assistant Professor of Ob/Gyn, >>Faculty of Medicine, Cairo University, Egypt. >> >Dear Professor Farag I have got a similar case with the same clinical and sonographic findings during my current MRCOG training at the Royal London Hospital. All the medical staffs including the paediatric surgeons were attending the meeting. The corner stone is to answer two questions; First, If this baby is delivered handicapped, his parents could cope with him or not?, Second, What is the medical and surgical advice received from the paediatric surgeons and the Diabetic team regarding the diabetic status. My view is you have to make a big discuusion with the parents, paediatric surgeons, diabetic team and social workers and try to clarify everything for them. By the way, in my hospital the team with the parents decided to terminate the pregnancy by Elective Cesaerean section. Baby is not good and had many major operations with very bad prognosis. By the way, I am a medical staff at El-Minya University Hospital and one of your students who are and will be very grateful for you for ever.
>SonoScan/Genetic Sciences
-- Dr. A.S. Talaat Assistant Lecturer of Obstetrics and Gynaecology El-Minya University Hospital Egypt Clinical visitor at the Royal London Hospital, UK
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