Re: Early Cardiac Function Predicts Miscarriage Risk
From: Latha Natarajan (nattu@bgl.vsnl.net.in)
Mon Dec 8 09:46:53 2003
Amazing !
Thanks for this, Dr. Moroder.
LN.
>----- Original Message -----
From: "Wolfgang Moroder, M.D." <wolfgang.moroder@tin.it>
To: "Multiple recipients of list ULTRASOUND" <ultrasound@dns.obgyn.net>
Sent: Monday, December 08, 2003 2:26 AM
Subject: Re: Early Cardiac Function Predicts Miscarriage Risk
> There is a tentative proof of how little oxygen the embryonic heart
> needs.
> One night I was on call in my ward and I diagnosed a tubal pregnancy at
> 8 weeks post mens. I took the patient to the OR, did a salpingotomy and
> gave the intact embryo to the nurse to put it in saline. After surgery
> I was still busy with some other urgent work and after some 60-80
> minutes I took the embryo to the ultrasound room to do some in vitro
> scanning. What I sow was quite impressive and you can see it if you
> download the ultrasound clip invitro.avi from here:
> http://mio.discoremoto.virgilio.it/moroder/invitro.avi
> please click on "salva" which means download in Italian. It will take
> some time since the clip is 1.5 MB.
> Well after the embryo of 8 weeks was kept more than an our in saline the
> heart was still beating.
> Maybe Terry you could publish this as a experimental case?
> Best regards
> Wolfgang
>
> At Thu, 4 Dec 2003, Terry J DuBose wrote:
> >
> >This message is in MIME format. Since your mail reader does not
understand
> >this format, some or all of this message may not be legible.
> >
> >----__JNP_000_2e2d.11ee.491b
> >Content-Type: text/plain; charset=iso-8859-1
> >Content-Transfer-Encoding: 8bit
> >
> >For some reason I can no longer respond to messages from my office... had
> >to forward this response home and send from there. Terry
> >------------------------------------------
> >Art, I saw this,... it is very interesting. The bit about lack of
> >------------------------------------------
> >------------------------------------------
> >------------------------------------------
> >oxygen in the embryonic period is new, I think:
> >------------------------------------------
> >
> >------------------------------------------
> >"The cause of embryonic congestive heart failure - not enough oxygen
> >------------------------------------------
> >reaching the heart - is much the same in embryos as it is in the
> >elderly," Dr. Birnholz said. "I suspect that if the blood vessels that
> >feed the placenta do not properly form or are slightly delayed in
> >development, the heart does not get the support required."
> >
> >Because the embryonic heart rate (EHR) acceleration and deceleration
> >curve has the shape of a classic "damping feedback curve" ( see:
> >http://www.obgyn.net/us/cotm/0001/ehr2000b.htm ), we have always thought
> >that there were probably 3 or more variables that control the shape of
> >the curve. In addition, because the curve peaks (9.2 LMP weeks) at about
> >the same time as the hCG and when the ventricular septum closes, we
> >assumed that the variables may include electrical (bundle of His & 2
> >branches
> >completion), hydraulic (VS closure), or hormonal (hCG curve), but did not
> >consider the oxygen. Of course, the oxygen might influence one or more
> >of the variables, including normal ventricular closure or other
> >development.
> >
> >I will be anxious to see the published research. both for the new
> >information, as well as to see if our work will be referenced.
> >DuBose TJ, Cunyus JA, Johnson LF; Embryonic Heart Rate and Age; J of
> >Diagnostic Medical Sonography; 6:151-157, 1990, May/June
> >
> >Peace, Terry J. DuBose, M.S., RDMS
> >Little Rock, Arkansas USA
> >
> >At Wed, 3 Dec 2003, art fougner, md wrote:
> >
> > Radiological Society of North America 03.12.2003
> >
> > Doppler ultrasound predicts risk of miscarriage
> >
> >Doppler ultrasound performed in early pregnancy can accurately identify
> >embryonic congestive heart failure and subsequent risk of miscarriage,
> >according to research being presented today at the 89th Scientific
> >Assembly and Annual Meeting of the Radiological Society of North America
> >(RSNA).
> >
> >"The chances the pregnancy will continue are very high, about 95
> >percent, when Doppler ultrasound confirms normal embryonic heart
> >function at six weeks," said the study's author Jason C. Birnholz,
> >M.D., president of Diagnostic Ultrasound Consultants in Oak Brook, Ill.
> >"Over 99 percent of pregnancies with an abnormal Doppler pattern do not
> >continue." The Doppler test measures the speed of red blood cells moving
> >through vessels to determine pressure dynamics within the embryo's
> >heart.
> >
> >Terry J. DuBose, M.S., RDMS, FSDMS, FAIUM
> >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/dms/default.asp
> >http://www.obgyn.net/us/panel/panel.htm
> >----__JNP_000_2e2d.11ee.491b
> >Content-Type: text/html; charset=iso-8859-1
> >Content-Transfer-Encoding: quoted-printable
> >
> ><!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.0 Transitional//EN">
> >
> >For some reason I can no longer respond to messages from my office..
> >hadto forward this response home and send from there. Terr
> >------------------------------------------Art, I saw this,... it i very
> >interesting. The bit about lack ofoxygen in the embryonic =
> >------------------------------------------Art, I saw this,... it i very
> >------------------------------------------Art, I saw this,... it i very
> >------------------------------------------Art, I saw this,... it i very
> >period
> >------------------------------------------Art, I saw this,... it i very
> >is new, I think:"The cause of embryonic congestive heart failure –
> >------------------------------------------Art, I saw this,... it i very
not
> >------------------------------------------Art, I saw this,... it i very
> >enough oxygenreaching the heart – is much the same in embryos as it
is in
> >theelderly," Dr. Birnholz said. "I suspect that if the blood
> >vessels that feed the placenta do not properly form or are slightly
delayed
> >in development, the heart does not get the support required."<BR Because
> >the embryonic heart rate (EHR) acceleration and decelerationcurve has the
> >shape of a classic “damping feedback curve” ( see:<A
> >href="http://www.obgyn.net/us/cotm/0001/ehr2000b.htm">http://www.obgyn
net/us/cotm/0001/ehr2000b.htm
> >), we have always thoughtthat there were probably 3 or more variables
that
> >control the shape ofthe curve. In addition, because the curve peaks
> >(9.2 LMP weeks) at aboutthe same time as the hCG and when the ventricular
> >septum closes, weassumed that the variables may include electrical
bundle
> >of His & 2branchescompletion), hydraulic (VS closure), or hormonal
> >(hCG curve), but did notconsider the oxygen. Of course, th
> >oxygen might influence one or moreof the variables, including normal
> >ventricular closure or otherdevelopment. I will b
> >anxious to see the published research… both for the newinformation,
as well
> >as to see if our work will be referenced.
> >DuBose TJ, Cunyus JA,
> >Johnson LF; Embryonic Heart Rate and Age; J of Diagnostic Medical
Sonography;
> >6:151-157, 1990, May/June Peace, Terry J. DuBose, M. .,
> >RDMSLittle Rock, Arkansas USAAt Wed, 3 Dec 2003, ar
> >fougner, md wrote: Radiological Society of North America
> >03.12.2003 Doppler ultrasound predicts risk of
> >miscarriageDoppler ultrasound performed in early pregnancy can
> >accurately identify embryonic congestive heart failure and subsequent
risk
> >of miscarriage, according to research being presented today at the 89t
> >Scientific Assembly and Annual Meeting of the Radiological Society of
North
> >America (RSNA)."The chances the pregnancy will continue are very
> >high, about 95 percent, when Doppler ultrasound confirms normal embryonic
> >heart function at six weeks," said the study’s author Jason C. 
> >Birnholz, M.D., president of Diagnostic Ultrasound Consultants in Oak
Brook,
> >Ill. "Over 99 percent of pregnancies with an abnormal Doppler pattern do
not
> >continue." The Doppler test measures the speed of red blood cells moving
> >through vessels to determine pressure dynamics within the embryo’s
> >heart.Terry J. DuBose, M.S., RDMS, FSDMS, FAIUM<BR Assistant
> >Professor & Director, Diagnostic Medical Sonography Program <BR
University
> >of Arkansas for Medical Sciences, CHRP 4301 West Markham St. Mail Slot
#563
> >Little Rock, Arkansas, 72205 USA 501-686-6510 <A
> >href="mailto:DuBoseTerryJ@UAMS.edu">DuBoseTerryJ@UAMS.edu <A
> >href="http://www.io.com/~dubose/">http://www.io.com/~dubose/ <A
> >href="http://www.uams.edu/chrp/dms/default.asp">http://www.uams.edu/chrp
dms/default.asp<A
> >href="http://www.obgyn.net/us/panel/panel.htm">http://www.obgyn.net/us
panel/panel.htm
> >
> >----__JNP_000_2e2d.11ee.491b--
>
> --
> Wolfgang Moroder, MD
> Prenatal Unit
> Bolzano General Hospital Italy
