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Re: Cord InsertionFrom: Philippe Jeanty (jeanty@TheFetus.net)Wed Nov 14 14:28:32 2001
Hum.. you are missing the cord insertion in the fetus ? any good pictures ? that surely sounds like a caput medusa form of ductal agenesis ! I would love to see these images ! Look at http://www.TheFetus.net > case of the week > case 10 Let me know -----Original Message----- From: ultrasound@obgyn.net [mailto:ultrasound@obgyn.net]On Behalf Of A. Parker-Money RDMS Sent: Wednesday, November 14, 2001 2:07 PM To: Multiple recipients of list ULTRASOUND Subject: Cord Insertion I was performing a scan on a 23week fetus. She was a late presentation to our clinic. We were confirming dates and a fetal screen. I performed a routine scan including all measurements, looking at the cerebellum, lat. vent, stomach, bladder, 4 chamber heart and spine. I was looking for the cord insertion and was unable to visualize it. The amt of amniotic fluid was 20.3cm. Therefore, there was plenty of fluid, the fetus was in an optimal position to see the abdominal wall. I began to look for the cord in general and could only find a small portion of the cord. It appeared to be 2 vessels and very thin. I looked for the insertion into the placenta and did find that. Unfortunatly, my machine is not equipped with doppler and/or color flow. I went and found the physician and asked her to come scan for the cord insertion ( feeling like somehow I had just forgotten how to scan after 20 years !!! ) The physician came and looked also, and was unable to see the cord insertion into the fetal abdomen. The fetal abdomen did look intact, we did not see anything that appeared to be a gastrosis and/or an omphalocele. We saw stomach, bladder, and the umbilical vein inside the abdomen, however it did look very small. In all my years of scanning I have never seen this before. We are sending the patient to a maternal fetal medicine office for further study. However, I was interested if anyone else has seen this and what it indicates. The fetus was one week behind from a sure lmp. Slight increase in amt of amniotic fluid for 23weeks and unable to see the cord insertion. If anyone has a solution to this interesting finding, I would be interested in the answer. Thank you, A Parker-Money, RDMS
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