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Re: PlacentalFrom: Philippe Jeanty, MD,PHD (jeanty@TheFetus.net)Fri Sep 21 10:31:55 2001
I think that the pathology is not a fold in the amnion but a doubling (like duplication of gastrointestinal segments). So you could conceive this as two pancakes (of amnion) fused at the edges with fluid in between. Now why should there be fluid in between is a little mysterious... in the old Ob textbooks one can read of membranes "producing" fluid. This is actually not true since the membranes do not actually "secrete" fluid but particulate matter in between could very well cause an osmotic pull of amniotic fluid or extracelluar fluid which would explain the "round" aspect of the cyst. I have no images on http://www.TheFetus.net but I have several cases... there are 98 articles in medline under placental cyst (no all relevant of course), so if there is a brave sonographer out there who would like to write the definitive opus for http://www.TheFetus.net I would be glad to contribute images. I am hesitant to just send the images here since I would have to edit the patient's identifications out of the images and this is a fair amount of work. I tried to embed a few images but they bounced... -----Original Message----- From: ultrasound@obgyn.net [mailto:ultrasound@obgyn.net] On Behalf Of DuBose, Terry Sent: Friday, September 21, 2001 9:47 AM To: Multiple recipients of list ULTRASOUND Subject: Re: Placental Dr. Jeanty, when you say "...doubling of the membrane with trapping of fluid in between." Do you mean the amnion is folded on itself or there were two amnions as in a "disappearing twin"? These cysts appear to be so spherical I don't understand the process. I would think a folded amnion would have more tapered edges, rather than spheres... but since I have never observed either I am just trying to imagine what the process would be an how it would appear. Are your "several such cases" on TheFetus? Do you have any histological images that would make this more clear for us? Could you give us URLs to them so we can compare them? Thanks for your participation. Peace, Terry J. DuBose, M.S., RDMS, APS 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: Philippe Jeanty, MD,PHD [mailto:jeanty@TheFetus.net] Sent: Friday, September 21, 2001 9:09 AM To: Multiple recipients of list ULTRASOUND Subject: Re: Placental I finally got a chance to look at the images on the link. These look to me like garden variety amniotic cyst. They are formed by a doubling of the membrane with trapping of fluid in between. They are not expected to cause any problems. I have several such cases. -----Original Message----- From: ultrasound@obgyn.net [mailto:ultrasound@obgyn.net] On Behalf Of Terry J DuBose Sent: Friday, September 21, 2001 9:03 AM To: Multiple recipients of list ULTRASOUND Subject: Re: Placental Dr. Moroder, very interesting... we will be anticipating the placental pathology on this case. I believe this is a rare case, what ever it represents. http://www.obgyn.net/us/us.asp?page=/us/present/0801/moroder Thanks again. Terry J DuBose, M.S., RDMS, APS ----------------------------------------------
At Thu, 20 Sep 2001, Dr. Wolfgang Moroder wrote:
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> -- ---------------------------------------------- >Content-Type: text/plain; charset=us-ascii >Content-Transfer-Encoding: 7bit > >The patient delivered on September 17, 2001 at 33+2 w weeks a heavily growth restricted, anatomically normal, female baby, BW 1240 grams (the inf 2nd SD for 33 w is 1342 g.) . Apgar 7,8 pH umb. Artery 7.28. The placental weight was 400 g. The umbilical cord was inserted on top of the described cyst, one of which ruptured presubebly before delivery. The neonate is at present (3rd day) doing fine. >I will send addition information on the placental pathology. > >-- >Wolfgang Moroder, M.D. >Prenatal Unit >General Hospital >Bolzano Italy >
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