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Re:In-Reply-To: <200101131727.BAA10169@ms1.mmh.org.tw>From: The-Hung Bui (The-Hung.Bui@ks.se)Mon Jan 15 05:40:55 2001
At 11:29 2001-01-13 -0600, you wrote: >Dear netters, > >I saw a fetus last Friday. Second trimester SGA. The mother was sure about >her >LMP and the gestational age was confirmed ealier by a dating scan at another >hospital. The gestational age was 21+ weeks, but the fetal size was >equivalent >to 18-weeks. The anatomical screening was normal, and no chromosomal markers >were found except mild dolichocephaly. The placental morphology was normal. >There was only a small and unilateral notch on the uterine artery Doppler >waveform, with normal PI. Liquor volume was around 3rd percentile. No PPROM. > >Placental insufficiency? > >The mother had a previous IUFD around 28 weeks because of hydrops fetalis. >The >previous fetus was also growth retarded. An FBS before fetal death revealed >severe fetal anemia. No infection or anomaly was identified. This is all the >information I have for the previous pregnancy. > >Well, my friends. First, what will you do next? Second, what will you >recommand >to scan for fetal anemia? > >Tung-yao Chang, MD >Dept. of obstetric and Gynecology, >Mackay Memorial Hospital, >Taipei, Taiwan. In addition to what has been already proposed (workup for IUGR including fetal infection and karyotype), you should screen both parents for alpha (in particular but also beta)-thalassemia (because some fetuses from Asia may have both disorder) in view of previous obstetric history and patient from Taiwan. ***************************************************************** The-Hung Bui, M.D. Senior Consultant -- Director, Fetal Diagnosis Programme Department of Molecular Medicine Clinical Genetics Unit Karolinska Hospital S-171 76 Stockholm, Sweden
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