Re: nuchal cords, etc
From: Dr. Gunjan Puri (drgap@vsnl.net)
Fri Jan 11 04:36:42 2002
what was the outcome
gunjan
>----- Original Message -----
From: Moot <moot@mediaone.net>
To: Multiple recipients of list ULTRASOUND
<ultrasound@mail.medispecialty.com>
Sent: Friday, January 11, 2002 10:22 AM
Subject: Re: nuchal cords, etc
> Attached is image from 38/40 wk gest. Indication: confirm vtx
presentation.
> Midwife patient. Will give outcome if anyone interested.
>
> Mary C. Scarboro
>
> -----Original Message-----
> From: ultrasound@obgyn.net [mailto:ultrasound@obgyn.net]On Behalf Of
Daniel
> Margulies
> Sent: Thursday, January 10, 2002 11:23 PM
> To: Multiple recipients of list ULTRASOUND
> Subject: RE: nuchal cords, etc
>
> Ok
> let`s imagine you tell nothing of nuchal cords
>
> Would you exclude a double or triple nuchal cord at term???
>
> I do inform complex nuchal cords
>
> Dani
>
>> ----- Original Message -----
> From: Philippe Jeanty <jeanty@TheFetus.net>
> To: Multiple recipients of list ULTRASOUND
> <ultrasound@mail.medispecialty.com>
> Sent: Thursday, January 10, 2002 12:10 PM
> Subject: RE: nuchal cords, etc
>
> > I think it really depends on how reassuring you are when you talk to the
> > patient. First I tell them that both of my kids had nuchal cord, second
we
> > use the analogy of the guy that would want to hang by jumping from a
> chair..
> > but in the uterus there is no place to jump from... my patients do not
> > seemed to be the least bit freaked out to know. I think that in the past
5
> > yrears we probably did not do 3 rescan for mom reassurance for nuchal
> cord.
> >
> > -----Original Message-----
> > From: ultrasound@obgyn.net [mailto:ultrasound@obgyn.net]On Behalf Of art
> > fougner, md
> > Sent: Thursday, January 10, 2002 9:01 AM
> > To: Multiple recipients of list ULTRASOUND
> > Subject: nuchal cords, etc
> >
> > to look or not to look ahhh there's the rub. my personal BIAS is that i
> > seldom ask a question if i don't know what to do with the answer. i get
> > asked about nuchal cords on a regular basis - my least fave is at 20 wk
> > scan. the earliest i have seen nuchal cord is at 15 wks. i certainly
> > would not be terribly keen on reporting this finding, let alone telling
> > the patient. in my neighborhood, telling the mom that there is a cord
> > around the baby's neck is like asking her to live under the sword of
> > damocles. these are situations akin to Roy Filly's "scary ultrasounds."
> > what you end up doing is turning this woman's happy pregnancy into a
> > nightmare existence.
> >
> > as for predictive value of ultrasound diagnosed nuchal cord - this is
> > unclear and thus unproven. additionally, since nuchal cord is found in
> > 20% of all deliveries, the significance of this finding remains to be
> > demonstrated. truthfully, many antepartum fetal demises written off as
> > "cord accidents" would probably be best left unexplained. i think that
> > the nuchal cord is simply one of Louie's "usual suspects" from
> > Casablanca.
> >
> > i do recall Dick Berkowitz advising me some time ago that he would never
> > look for a nuchal cord and if seen would not report it - the ol
> > clintonian "don't ask, don't tell." prolly the only subgroups with
> > nuchal cord we do need to know about are the breeches about to undergo
> > external version and those fetuses whose movements have markedly
> > decreased. a tough situation to be sure and i thank god when i can
> > answer the patient in the negative.
> >
> > i truly don't think there is a right answer but there can be many wrong
> > answers. just my opinion - i could be wrong.
> >
> > art
> >
> > --
> > art fougner, md
> > ich bin ein New Yorker
> >
>
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