ULTRASOUND Messages for November, 2001: Re: Cord Insertion

Re: Cord Insertion

From: Philippe Jeanty

jeanty@TheFetus.net

Wed Nov 14 15:19:40 2001

http://www.TheFetus.net

-----Original Message----- From: ultrasound@obgyn.net [mailto:ultrasound@obgyn.net]On Behalf Of A. Parker-Money RDMS Sent: Wednesday, November 14, 2001 4:17 PM To: Multiple recipients of list ULTRASOUND Subject: Re: Cord Insertion

Dr. Jeanty, It did appear we were missing the cord insertion, I do have images, I will get them scanned and send them to you. We absolutely could not image the cord inserting in the fetal abdomen. I have a really nice image of the fetus on it's back and can see the whole abdominal wall, no cord is even seen around the abdomen. I searched through out the whole uterus and could only find one area of cord, which was very small and the walls of the cord were very thin.

Altho, I having been scanning for many years and probably should know what "caput medusa form of ductal agenesis" actually is, I do not. Could you explain.

Thank you for your response, again I will scan the images and send them. A Parker-Money RDMS

At Wed, 14 Nov 2001, Philippe Jeanty wrote: >
>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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