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My reply to Lynn - Thank you
From: mary (anonymous@obgyn.net)
Thu, 28 Dec 2000 10:07:18 -0600 (CST)
its about 4 1/2 hours away. If I decide to go for another preg - I will
make sure that it is not during the winter! ha ha ha its snowing here
today like crazy. thanks.
At
Thu, 28 Dec 2000, Lynn D. Montgomery, MD wrote:
>
>At Thu, 28 Dec 2000, mary wrote:
>>
>>I live in Maine. I think I would have to travel to the Boston area
>>which worries me cause it is a 2 hour drive in good weather, a day like
>>today could take 3-4. If none of this happened to me I know I would
>>have another child, now it just seems that I dont have much confidence
>>in my past Dr's or the testing methods. A friend in S. Africa has sent
>>me some info on plasmapheris which is an option too. I guess I need to
>>find a Dr with experience in RH cases. Any recommendations?
>
>Joncarlo Mari, who is the primary researcher/inovator of the middle
>cerebral artery technology is at U Conn in New Haven. That would be
>fairly close to you...
>Lynn
>>
>>At Wed, 27 Dec 2000, Lynn D. Montgomery, MD wrote:
>>>
>>>At Wed, 27 Dec 2000, mary wrote:
>>>>
>>>>Hi - me again.
>>>>
>>>>RH sensitized to D, one normal pregnancy, one affected child - no Rhogam
>>>>shot at 28 weeks, no screen.
>>>>
>>>>I may have already asked this, months ago - my apologies if I did, I am
>>>>brain dead after the holiday. I am trying to figure out if I were to
>>>>get prego again, how the best way to be monitered is. With the last
>>>>preg, I had ultrasounds at 34,35 and 36 weeks, nothing was picked up
>>>>until 36 weeks, but then again they werent looking for anything but
>>>>polyhydraminos which was at 27, 28 and then 29 at 36 weeks. I had an
>>>>amnio the day of delivery (36 weeks) and that is where they diagnosed RH
>>>>Disease, and the amnio caused contractions. I had a blood test the day
>>>>of delivery and the titers were 8, which I think was incorrect as 6
>>>>months later I had them retested cause it didnt make sense, and they
>>>>were 256. Can you rely solely on ultrasounds and titers to track
>>>>anemia/jaundice or do you really have to do amnios? But if you do an
>>>>amnio arent you running the risk of causing the fetal/maternal blood
>>>>exchange if it hasnt happened yet or causing contractions ? I am not
>>>>really too thrilled with any of the methods of tracking cause in the
>>>>past I have experienced so many mistakes of things that dont make sense.
>>>>I do not have a perinatologist to talk to about this in my area.
>>>
>>>First, where are you located? I would have to say that if your baby was
>>>affected with your last pregnancy, the titer of 8 was an error. Given
>>>that, the method of following your next pregnancy in my book is to begin
>>>assessing middle cerebral artery velocities via doppler ultrasound at
>>>18-20 weeks. This can also be substituted with amnios, but I do not do
>>>these any longer now that the middle cerebral data have been quite
>>>definitively proven.
>>>You could also be more conservative and follow blood titers to 16, then
>>>begin the amnios or middle cerebral monitoring at that point. However,
>>>in your case of possible titer trouble, this might be risky for missing
>>>something developing...
>>>Lynn
>>>
>>>--
>>>Lynn D. Montgomery, MD
>>>Director, Maternal-Fetal Medicine
>>>Rocky Mountain Perinatal Center
>>>Missoula, Montana
>>>
>>>**Note: Opinions expressed here are for educational purposes only and, as such, do not constitute a physician-patient relationship. This information is not intended to supplant the need for you to consult with your physician prior to choosing therapeutic options and/or interventions.
>>>
>>>**Private e-mails cannot be entertained due to time constraints, consequently no private e-mails will receive a response.
>>>
>>>**Thank you for your understanding ;-)
>>>
>--
>Lynn D. Montgomery, MD
>Director, Maternal-Fetal Medicine
>Rocky Mountain Perinatal Center
>Missoula, Montana
>
>**Note: Opinions expressed here are for educational purposes only and, as such, do not constitute a physician-patient relationship. This information is not intended to supplant the need for you to consult with your physician prior to choosing therapeutic options and/or interventions.
>
>**Private e-mails cannot be entertained due to time constraints, consequently no private e-mails will receive a response.
>
>**Thank you for your understanding ;-)
>
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