Re: Computerized Reporting Packages

From: Terry J DuBose (tjdubose@juno.com)
Sat Oct 25 07:19:17 2003


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Rich, I agree with Dr. Moroder, the fetus does sound like asymmetric IUGR. Did you do a RI on the umbilical arteries and MCA?

As to computerized reporting packages, I do trust them, but I am not familiar with OB/WIN. For growth differentials, I think all exam calculations need to be done using the same calculation package or charts... there are slight differences in many.

It would be interesting and instructive if, as Dr. Moroder suggested, you could post the LMP, specific dates and all measurements for each examination. Then perhaps we both (& others?) could plug the data into our favorite software package and see the various results. Of course, if the case was already at 39.5 weeks yesterday with IUGR, this is going to be an academic exercise.

Please let us know what the outcome is. Thanks, Terry

On Fri, 24 Oct 2003 19:15:19 -0500 ridem@msn.com (Rich Dempsey RDMS/RVT ) writes: > I had a patient today who was 39.5 weeks and "small for dates", to
> check
> amniotic fluid volume and fetal weight. The AFI was 6, which is
> considered "low-normal" here. Subjectively, it looked like
> oligohydramnos. I work at an off-site, there is no physician
> on-site,
> no TeleRad no PACS.
>
> The BPD and head circumference were in the 56% range, BUT the femur
> length and abdominal circumference were <5% for gestational age.
> (A
> full 3 weeks behind expected range). Patient had been scanned at 6
> ,
> 18, and 25 weeks. Previous interval growth parameters were normal.
>
> My question is this : the reporting package we use (OB/WIN) reported
> the
> estimated fetal weight at 6lbs / 9 oz- which is in the 47 th
> percentile
> with this software package. Obviously something is wrong here.
>
> How much trust do you place in automated reporting packages?
>
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Rich, I agree with Dr. Moroder, the fetus does sound like asymmetric IUGR.  Did you do a RI on the umbilical arteries and MCA?

 

As to computerized reporting packages, I do trust them, but I am not familiar with OB/WIN.   For growth differentials, I think all exam calculations need to be done using the same calculation package or charts... there are slight differences in many.

 

It would be interesting and instructive if, as Dr. Moroder suggested, you could post the LMP, specific dates and all measurements for each examination.  Then perhaps we both (& others?) could plug the data into our favorite software package and see the various results.   Of course, if the case was already at 39.5 weeks yesterday with IUGR, this is going to be an academic exercise.

 

Please let us know what the outcome is.   Thanks, Terry  

 
On Fri, 24 Oct 2003 19:15:19 -0500 ridem@msn.com (Rich Dempsey RDMS/RVT ) writes:
> I had a patient today who was 39.5 weeks and "small for dates", to
> check
> amniotic fluid volume and fetal weight.  The AFI was 6, which is
> considered "low-normal" here.  Subjectively, it looked like
> oligohydramnos.  I work at an off-site, there is no physician
> on-site,
> no TeleRad no PACS.
>
> The BPD and head circumference were in the 56% range, BUT the femur
> length and abdominal circumference were <5% for gestational age. 
> (A
> full 3 weeks behind expected range).  Patient had been scanned at 6
> ,
> 18, and 25 weeks.  Previous interval growth parameters were normal.
>
> My question is this : the reporting package we use (OB/WIN) reported
> the
> estimated fetal weight at 6lbs / 9 oz- which is in the 47 th
> percentile
> with this software package.  Obviously something is wrong here.
>
> How much trust do you place in automated reporting packages?
>
>
>
 
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