ULTRASOUND Messages for July, 2002: Re: FW: hydrocephalic twin

Re: FW: hydrocephalic twin

From: Allen Worrall

jworrall@alaska.net

Tue Jul 16 12:32:50 2002

Allen

> ----- Original Message -----
From: art fougner, md To: Multiple recipients of list ULTRASOUND Sent: Tuesday, July 16, 2002 6:45 AM Subject: Re: FW: hydrocephalic twin

not sure what ovarian carcinoma has to do with this case but chorionicity is not diagnosable from these images. were there earlier scans? the profile images are mislabeled - the normal labeled abnormal and vice versa. nevertheless - would suggest karyotyping both fetuses here prior to any definitive therapy. if this in fact is a monochorionic placentation, then selective feticide is problematic. if chorionicity is in doubt would opt for observation only. if dichorionic - could entertain selective termination. if monochorionic - and patient opts for selective termination - then would advise cord ligation/coagulation via fetoscopy ( not for the upslope of the learning curve). the problem with invasive procedure is that the unaffected twin is placed in harm's way as well. sad case.

art

At Tue, 16 Jul 2002, DuBose, Terry wrote: >
>The following urgent case has been submitted for discussion on the
>Ultrasound Section and Forum. Please direct the discussion to the Ulrasound
>Forum so all can participate.
>
>http://www.obgyn.net/us/us.asp?page=/us/present/0207/nikolaev_hydrocephalict
>win
><http://www.obgyn.net/us/us.asp?page=/us/present/0207/nikolaev_hydrocephalic
>twin>
>
>Thank you,
>
>Susan
>
>Susan Dale
>OBGYN.net Section Coordinator
>Susan.Dale@obgyn.net <mailto:Susan.Dale@obgyn.net>
>

> >>----- Original Message -----
>From: DuBose, <mailto:DuboseTerryJ@uams.edu> Terry
>To: 'nikolaev <mailto:nikolaev@gol.ge> vladimir' ; DuBose, Terry
><mailto:DuboseTerryJ@uams.edu> ; Susan. Dale (E-mail)
><mailto:Susan.Dale@medispecialty.com>
>Cc: Daniel.Margulies@obgyn.net <mailto:Daniel.Margulies@obgyn.net>
>Sent: Monday, July 15, 2002 8:25 AM
>Subject: Re: hello
>
>Dr. Vladimir, because I am not a physician, I will decline from giving
>management consultations... however, if you would like we can post this case
>as an " urgent " case for quick comment from other participants.
>
>Peace, Terry J. DuBose, M.S., RDMS
>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.io.com/~dubose/>
>http://www.uams.edu/CHRP/dmshome.htm <http://www.uams.edu/CHRP/dmshome.htm>
>http://www.obgyn.net/us/panel/panel.htm
><http://www.obgyn.net/us/panel/panel.htm>
>
>-----Original Message-----
>From: nikolaev vladimir [mailto:nikolaev@gol.ge]
>Sent: Friday, July 12, 2002 4:28 AM
>To: DuBose, Terry
>Cc: Daniel.Margulies@obgyn.net
>Subject: hello
>
>Dear Mr. DuBose and Daniel,
>How doYou do? I hope You are OK.
>I would like to know Your opinion of this case.
>
>20 years female. Gravida 1. Gestational age 23 weeks. Biamniotic twins.
>Hydrocephaly, meningocele and micrognathia one in a two fetuses and moderate
>hydramnion.
>
>I think so:
>
>Plan
>
>1. heart arrest of invalid fetus.
>
>2. partial evacuation of amniotic fluid.
>
>3. further ultrasound control.
>
>I am panning this manipulation next Saturday.
>
>Thank You,
>
>Vladimir

-- art fougner, md ich bin ein New Yorker

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