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Re: Cystic structure off herniated bowelFrom: Bill King (billking@cros.net)Fri Sep 14 15:04:55 2001
Thank you for your comments regarding the cystic structure off the herniated bowel. Even though I have been performing ultrasounds since 1981, I seem to learn something new almost every day. I am aware of the fetal age criteria for the Nicholaides study. I mentioned nuchal region only because I have seen cystic hyroma, and omphalocele as early as 10 weeks. I have seen cord cysts near the fetal insertion in early pregnancy and agree that of the cord cysts seen in our office, in the first trimester, there have been no obvious defects on later scan, or obvious at birth. Our physician will probably offer amniocentesis only because the patient is over 35 years old. Amniocentesis is something the physicians discuss the risks -vs- benefits with any patient over 35. (We seldom have patients take the option of amniocentesis). I will try to scan an image and send it. I find it reassuring that is probably a cord cyst. Thank you to the people from around the world who have been sending words of comfort regarding the terrible terrorist acts of violence in Washington, Penn, and New York. We are all affected by this disregard for life. Your thoughts and prayers mean more than you will ever know. Ruth A. King RT, RDMS Bayshore OB/GYN From: Allen Worrall [mailto:jworrall@alaska.net] Sent: Wednesday, September 12, 2001 11:18 PM To: Multiple recipients of list ULTRASOUND Subject: Re: Cystic structure off herniated bowel 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 ------_=_NextPart_001_01C13C59.EA114200
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