Re: PI umbilical cord doppler
From: Terry J DuBose (TJDuBose@juno.com)
Sun Mar 25 10:16:55 2001
Dr. Margulies, your are correct; I agree completely. Thanks for
pointing out the important issues in this discussion.
--
Terry J DuBose, M.S., RDMS, APS
Little Rock, Arkansas USA
-------
At Fri, 23 Mar 2001, Daniel Margulies wrote:
>
>I am using Doppler in OB since 1989
>Don't feel that any index is better than other.
>The patency and sufficiency of the placenta ( that is what you interrogate
>when doing umbilical doppler) is not change by little difference in a
>number.
>When You see pathology on the placenta the diastolic flow is low, there is
>an increase in the pulsatilitiy there is a change in the waveform with a
>thinner and sharper form over the peak sistole. There is no difference
>between IR 0.87 and 0.81. Remember the physiologic changes on the fetus.
>Breathing, etc.. There is a more bigger diference between healthy and sick
>placentas. Don´t forget the simple AB ratio which is simpler and absolutely
>the some as de RI . Remember You are using the same number in the
>formula......
>-----------------------------------------------------
>
>-----------------------------------------------------
>-----Mensaje original-----
>-----------------------------------------------------
>De: DuboseTerryJ@uams.edu <DuboseTerryJ@uams.edu>
>Para: Multiple recipients of list ULTRASOUND
><ultrasound@mail.medispecialty.com>
>Fecha: Jueves, 22 de Marzo de 2001 11:46 a.m.
>Asunto: RE: PI umbilical cord doppler
>
>>Do you believe that the PI is better than the RI for evaluating fetal
>>well-being? I realize that theoretically the PI may be more sensitive to
>>changes in systolic vs diastolic flow, but it is much more difficult to
>>calculate unless you have very new equipment that automatically traces out
>>the wave form. On older machines it seems that the calculation of the PI
>is
>>much more error prone and time consuming.
>>
>>As for the question "What is the accepted variance in PI for cord doppler?"
>>Because it changes (negative correlation with age) as gestation progresses,
>>wouldn't one need to refer to a chart or graph for the best evaluation of
>>variance, depending upon the gestation age rather than using a single,
>>arbitrary number?
>>
>>Any opinions?
>>
>>Terry J. DuBose, M.S., RDMS, Assistant Professor
>>Director, Diagnostic Medical Sonography Program
>>CHRP, University of Arkansas for Medical Sciences
>>Little Rock, Arkansas, USA
>>501-686-6510
>>http://www.io.com/~dubose/
>>http://www.uams.edu/CHRP/dmshome.htm
>>http://www.obgyn.net/us/panel/panel.htm
>>
>>-----Original Message-----
>>From: Kilavuz@aol.com [mailto:Kilavuz@aol.com]
>>Sent: Wednesday, March 21, 2001 6:12 PM
>>To: Multiple recipients of list ULTRASOUND
>>Subject: Re: PI umbilical cord doppler
>>
>>Dear Debbie,
>>I am senior register in a hospital in Berlin - Germany. In Germany the
>>doctors are doing Ultrasound- Doppler examminations.
>>We have here a lot experience about prenatal Doppler.
>>Your question is one of the most important thing in our duty. So I think
>you
>>should accept the best value of PI or S/D ratio in cases between 24-32 GWs.
>>For the prevent very preterm deliveries. In cases with pathological
>Doppler
>>above 32 GWs we should not to wait so long time.We should deliver them , so
>>I think we should accept the highest values.
>>
>>Best regards,
>>Ömer Kilavuz
>>
