Re: fetal Heart rate....Basic/Advance OB ultrasound report
From: Dr Fazeel uz Zaman (fazeel@atd.hazara.net.pk)
Tue Aug 7 14:56:14 2001
Dear Terry,
You have a great interest in fetal heart rates.........did you also observe
this?....
In a local ultrasound conference in Pakistan, a doctor presented a paper that
female fetuses tend to have faster heart rates (probably she coated 146/min
and above) than male fetuses.....and she accurately predicted fetal heart
when not seen the gender yet.....as in early pregnancy or even in late
pregnancy.
Dr.Fazeel
Terry J DuBose wrote:
> I agree with this list of observations and measurements for obstetrical
> sonography, it is very complete. If there are any suspicious findings
> then we look further, of course.
>
> In addition, I like the heart rate documented with M-mode, and before 9.2
> LMP weeks I compare the EHR and CRL ages (see:
> http://www.obgyn.net/us/cotm/0001/ehr2000.htm; Jan 2000).
>
> I do a 3D BPD Correction if there is any molding or head shape question.
> For the abdomen, I like a coronal image of the abdomen showing the
> relationship of the heart, stomach, and bladder. This coronal oblique
> view also facilitates observations of the relationships and textures of
> the liver, bowel, lung, and diaphragm, among other things that Nayana
> lists below.
>
> One observation that very few make is measuring the liver when the
> abdominal circumference appears large compared to the head circumference.
> The reason is that the liver and spleen often are enlarged, and the head
> small with fetal infections, and I find that a HC/AC too low for the age
> is a fair screen visceral enlargement (this needs more research).
>
> Of course your question was about what goes into the report. Because I
> am a sonographer (ARDMS) and not a licensed physician, I do not always
> decide what goes into the final medical report... but the above and what
> Nayana of India lists below are what I routinely attempt to provide in
> every case.
>
> Also agree with Nayana that "I personally feel that every obs scan
> warrants detailed examination...." The subsequent exams are very
> important for evaluating whether fetal growth in time is normal or not,
> and thus well being. Serial exams offer another look for subtle
> findings, and as the fetus gets larger these are easier to see.
>
> I do not like "limited exams" and the current tendency to believe that a
> "limited exam" implies that it only requires "limited ultrasound specific
> education and experience". Of course, in the USA medicine is now
> controlled by HMOs and the insurance corporations who do not want to pay
> for more than one sonographic examination for each pregnancy. And in many
> settings, the schedule is so rushed that it is difficult to do all that
> can and should be done even in the one they allow. For profit health
> care seems to have become "You money or your life." Don't get me
> started....
>
> Peace, Terry J DuBose
> Little Rock, Arkansas, USA
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