Re: Two Yolk Sacs, one embryo
From: Terry J. DuBose (duboseterryj@uams.edu)
Wed Jan 22 07:44:29 2003
With "
>LMP : 6 weeks and CRL 5 weks and 5 days.
" and an EHR of 119 B/M which calculates to 5.9 weeks or 5w6.7 days, the heart rate is absolutely normal for the age. The follow-up on Jan 31 will be 7.3 weeks, and I will predict that the hear rate will be near 151 at that time... and you will likely find a second CRL and heart rate that will be corresponding smaller and slower.
Can't wait to here what happens. Terry
ultrasound@obgyn.net writes:
> Terry and friends
>
>I'm worry about conjoined twins possibility in this case.During scan I can't separate the two yolk sacs.I agree that in some days the other embrio will appear.Very interesting your article about EHR and IG.In this case the EHR of the embrio is 119 bpm.
>Dr.Corda, the YS diameters is 3.7mm(embrio) and 3.5mm(non-embrio).
>The patient will return in January 31.I'll post the follow up.
>
>Regards
>
>Mário
>
>>----- Original Message -----
>From: [ mailto:duboseterryj@uams.edu ]Terry J.
> DuBose
>To: [ mailto:ultrasound@mail.medispecialty.com ]Multiple recipients of list
> ULTRASOUND
>Sent: Tuesday, January 21, 2003 9:23 PM
>Subject: Re: Two Yolk Sacs, one embryo
>
>My first thought is that if you wait 3-4 days, the other twin will show up... I have seen cases where one twin was larger than the other by up to 6 days... and their heart rates correlated with their CRL sizes both in the acceleration and deceleration phases. Our hypothesis was that when the cell mass split, one twin got a larger mass of cells. Both were normal, but remained about a week different in size until delivery. Check out this article:
>
>[ http://www.obgyn.net/english/pubs/features/dubose/ehr-age.htm ]http://www.obgyn.net/english/pubs/features/dubose/ehr-age.htm
>particularly this image:
>[ http://www.obgyn.net/english/pubs/features/dubose/Image16.gif ]http://www.obgyn.net/english/pubs/features/dubose/Image16.gif
>
>I also described this set of twins in detail in FETAL SONOGRAPHY, p. 151-154.
>
>Or you may need to watch for conjoined twins later.
>
>Either way, please follow this one, give us feed back... and get accurate measurement on the CRL and EHR over the next month. Interesting case.
>
>Good luck. Terry J DuBose.
>
>[ mailto:ultrasound@obgyn.net ]ultrasound@obgyn.net writes:
>> Patient with 25 years old, G2P1A0, LMP : 6 weeks and CRL 5 weks and 5 days .
>>
>>US findings:
>>Two yolk sacs side by side, but only one embryo identified.
>>
>>Opinions ?? Suggestions ???
>>
>>Regards
>>Mário Libardi, M.D.
>>Multimagem Ultra-sonografia
>>Botucatu - Sao Paulo
>>Brazil
>
>Peace, Terry J. DuBose, M.S., RDMS
>Assistant Professor & Director, Diagnostic Medical Sonography Program
>University of Arkansas for Medical Sciences, CHRP
>4301 West Markham St. Mail Slot #563
>Little Rock, Arkansas, 72205 USA
>501-686-6510
>[ mailto:DuBoseTerryJ@UAMS.edu ]DuBoseTerryJ@UAMS.edu
>[ 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
>
Peace, Terry J. DuBose, M.S., RDMS
Assistant Professor & Director, Diagnostic Medical Sonography Program
University of Arkansas for Medical Sciences, CHRP
4301 West Markham St. Mail Slot #563
Little Rock, Arkansas, 72205 USA
501-686-6510
DuBoseTerryJ@UAMS.edu
http://www.io.com/~dubose/
http://www.uams.edu/CHRP/dmshome.htm
http://www.obgyn.net/us/panel/panel.htm
