Re: Two Yolk Sacs, one embryo
From: Terry J DuBose (tjdubose@juno.com)
Mon Jan 27 06:38:34 2003
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I agree, that we do not see the "double bleb" very often. That is why I
assumed it only exists for a short period of time, few days, before the
amnion becomes large enough to be recognizable as the amnion. I will see
if I can find some information about the relationship of the amnion and
yolk. But if the yolk sac develops first, it is logical that at some
point the amnion and yolk will be the same size for a brief period before
the amnion becomes larger... why we don't see it more often is the
question.
I do remember seeing the double-bleb a few times in the early 90's.
Hopefully, as more and more get better machines we will get better
examples... and an understanding of the process.
I don't know why I didn't think about it when we first saw Dr. Libardi's
image... synapse failure is my only excuse. The follow-up on this case
will be interesting.
Peace, Terry J DuBose
On Mon, 27 Jan 2003 06:14:31 -0600 womorode@tin.it (Wolfgang Moroder, MD)
writes:
> I was never happy with the term double bleb sign - as far as I
> remember
> forged by a radiologist in the eighties. I was never able to
> reproduce
> it even now that I hav a nice vaginal probe (10MHz). I have
> observed a
> disproportion between the early embryonic size and the amniotic sac
> diameter ONLY in cases of early embryonic failure.
> We all wait for Marco Libardi telling us the end of the story.
> Wolfgang
>
> At Sun, 26 Jan 2003, Terry J DuBose wrote:
> >
> >The "double bleb" seems to have a fairly short period of time. It
> would
> >be interesting to know when the diameters of the yolk sac and
> amnion are
> >identical, and the rate of change of the two.
> >
> >Looking through the web sites, Dr. Libardi’s image is the best of
> >examples I have found.
> >
> >This web site states
> >http://www.ohsu.edu/ps-DiagRadiol/kojima/nliup.htm
> >• Double bleb sign-smaller amniotic sac, yolk sac, and prochordal
> plate
> >seen between. Seen at 4-5 wks.
> >
> >There were 5 hits on a Google search:
> >
> >Bombay Hospital Journal - Original Research Article - YOLK SAC ...
> >... Fig 2 : Yolk sac with embryo and amniotic sac complex. Double
> bleb
> >appearance .Transnational
> >scan at 7 menstrual weeks shows a well defined yolk sac and embryo.
> ...
> >http://www.bhj.org/journal/oct97/original_01.htm - 74k - Cached -
> Similar pages
> >US Normal IUP
> >... 31 + " days. Double bleb sign-smaller amniotic sac, yolk sac,
> and
> >prochordal plate seen between. Seen at 4-5 wks. Double decidual
> ...
> >http://www.ohsu.edu/ps-DiagRadiol/kojima/nliup.htm - 10k - Cached -
> Similar
> >pages
> >Ecografia Primer Trimestre - [ Translate this page ]
> >... Yeh HC, Rabinowitz JG. Amniotic sac development : Ultrasound
> >features
> >of early pregnancy-the double bleb sign. Radiology 1988 ;166:197.
> ...
> >http://www.tocogineconet.com.ar/revisiones/ ecografia1trimestre.htm
> - 39k -
> >Cached - Similar pages
> >[PDF]The first trimester
> >File Format: PDF/Adobe Acrobat
> >... This pro- duces the `double bleb' sign that is regularly
> described
> >in texts as occurring
> >at about 5.5 weeks, menstrual age, but which is rarely seen because
> it
> >...
> >http://www.harcourt-international.com/meire/Vol3Chap7.pdf - Similar
> pages
> >Sonoembryologie
> >... 18. Yeh, H., Rabinowitz, J.: Amniotic sac development :
> ultrasound
> >features
> >of early pregnancy-the double bleb sign.Radiologi 166, 1988, s.
> 97. 19.
> >...
> >http://www.levret.cz/vol/fulltext/sonoemb/sonoembryologie.htm - 46k
> - Cached -
> >Similar pages
> >
> >Embryosonography is very interesting to me, and isn’t this fun?
> >
> >--
> >Peace, Terry J DuBose, M.S., RDMS, FAIUM, FSDMS
> >Chair, Ultrasound @OBGYN.net
> >Diagnostic Medical Sonography Program
> >Univ. Arkansas for Medical Sciences
> >Little Rock, Arkansas USA
> >
>
> --
> Wolfgang Moroder, MD
> Prenatal Unit
> Bolzano General Hospital Italy
>
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