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Re: Two Yolk Sacs, one embryo From: Terry J. DuBose (duboseterryj@uams.edu) Mon Jan 27 09:32:06 2003 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Wolfgang Moroder, MD: "Re: Two Yolk Sacs, one embryo" Previous message: Dave Berck: "New Ob ultrasound billing codes" In reply to: Philippe Jeanty. MD, PhD: "Re: Two Yolk Sacs, one embryo" Next in thread: Wolfgang Moroder, MD: "Re: Two Yolk Sacs, one embryo" In looking at a couple of embryology textbooks, it does appear that the embryo should be developing between the two halves of the "double bleb". In the current images, this is not the case... http://www.obgyn.net/us/us.asp?page=/us/present/0301/libardi_oneembryo I will send a scaned figure to be attached to the case. There should be someone here well enough versed in embryology to explain this. The textbooks, none with scales included, have illustrations that show the secondary yolk sac and the amnion at about the same size at about 20-21 days after conseption (34-35 LMP days), this is also approximately when the heart starting to beat. According to Langman's and Moore & Persaud, the embryo and heart should be between the yolk and amnion... as pointed out by Dr. Art Fougner. So I don't think we have a good answer for what we are actually seeing in these two images... yet. Interesting. Peace, Terry J DuBose, M.S., RDMS ultrasound@obgyn.net writes: >If if remember well the double bleb sign of Dr. Yeh was discussed at one SRU >meeting on day, and we came to the conclusion that the sign could not >represent the early amnion and primitive yolk sac because when these are >present the embryo was too small to been seen by US. So certainly not the >size seen in the pictures that were circulated. > > -----Original Message----- >From: ultrasound@obgyn.net [mailto:ultrasound@obgyn.net] On Behalf Of >Terry J DuBose >Sent: Monday, January 27, 2003 7:41 AM >To: Multiple recipients of list ULTRASOUND >Subject: Re: Two Yolk Sacs, one embryo > >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 >> > Next message: Wolfgang Moroder, MD: "Re: Two Yolk Sacs, one embryo" Previous message: Dave Berck: "New Ob ultrasound billing codes" In reply to: Philippe Jeanty. MD, PhD: "Re: Two Yolk Sacs, one embryo" Next in thread: Wolfgang Moroder, MD: "Re: Two Yolk Sacs, one embryo"

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