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Re: Cystic structure off herniated bowelFrom: Allen Worrall (jworrall@alaska.net)Wed Sep 12 23:14:26 2001
The herniated midgut does go into the umbilical cord, so you probably did see the umbilical cord vessels when you put color on. Because the herniated midgut is within the cord, I would think it difficult to say that this cystic structure was not part of the cord. Certainly follow-up scan at 14 weeks is a good thing to do, but why don't you make it 13 weeks so you can do a valid nuchal translucency? Although I cannot tell you what your cyst is, my experience with small cysts of the umbilical cord has been perfectly benign: I have seen three or four, all at the fetal end of the cord and none of those fetuses have had a problem, and none of these cystic structures could be found at subsequent ultrasound examination. And of course you would want to do an anatomic survey around 18-22 weeks. My gut feeling is that planning an amniocentesis just on the basis of this finding is a little much. Nuchal translucency at 10 weeks? The work done by Professor Nicholaides and his group, and the significance of increased nuchal translucency, applies only from CRL 45 mm to CRL 85 mm, which is about 11 weeks 0 days to 13 weeks 6 days, depending on exactly which table you use. That's not to say that an increased nuchal translucency cannot be found at 10 weeks 0 days, but in this case I would do the next ultrasound within that window so that your report of the nuchal translucency will have more "weight". Please be sure and let us know how this turns out. Joseph A Worrall MD RDMS
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