Re: Nuchal Cord
From: art fougner, md (evsono@pipeline.com)
Fri Feb 20 07:34:43 2004
asked this question of Dick Berkowitz about 15 yrs ago - his reply about
nuchal cord was akin to Clinton's policy on gays in the military -
"Don't ask - don't tell." in NY - with possibly the highest population
density of attorneys on the planet - folks really don't find the news "
Your baby has a loop of cord around the neck - but don't worry - it
looks loose and won't be a big deal" - terribly comforting. living
under the sword of damocles is a bummer.
before you ask the question - you really need to know what to do with
the answer.
just my opinion - i could be wrong.
Art
At Thu, 19 Feb 2004, DuBose, Terry wrote:
>
>As I understood the original question, it was not the sonographer
>telling the patient about the cord, but the physician did not want to
>know if the cord was just draped over the fetal shoulder, with a film
>showing this, because the physician then felt obligated to comment in
>the report about in case there was a poor outcome.
>
>So should the sonographer take a picture of a nuchal cord that does not
>encircle the neck two or more times? Or ignore it... that is the
>question, as I understand it.
>
>Sonographers are expected to take diagnostic images, but not considered
>a diagnostician, even though their credential is "Registered Diagnostic
>Medical Sonographer". They are between a rock and a hard place with
>many physicians.
>
>Peace, Terry J. DuBose, M.S. RDMS
>Little Rock, Arkansas
>
>------------------------------------
> I absolutely agree......why is a sonographer telling the patient
>------------------------------------
>------------------------------------
>------------------------------------
>about the cord? Perhaps a policy should be put in place that the
>
>--
>------------------------------------
>sonographer tells the doc about the cord, then leaves it up to the doc
>------------------------------------
>to tell the pt.
>------------------------------------
>
>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
>---------------------------------------------------------------
>
>---------------------------------------------------------------
>-----Original Message-----
>---------------------------------------------------------------
>---------------------------------------------------------------
>From: ultrasound@obgyn.net [mailto:ultrasound@obgyn.net] On Behalf Of
>---------------------------------------------------------------
>---------------------------------------------------------------
>Ilvlucy@aol.com
>Sent: Thursday, February 19, 2004 5:19 PM
>To: Multiple recipients of list ULTRASOUND
>Subject: Re: Nuchal Cord
>
>In a message dated 2/19/2004 4:28:18 PM Central Standard Time,
>sue@aiu.edu.au writes:
>
> If I could buy into this one - surely a sonographer is duty
>bound to examine
> the fetus in all its aspects and document the findings. We
>routinely include
> cord examination in third trimester scans, it is the
>obstetrician's duty to
> discuss the results with the patient and make decisions on
>management, if a
> sonographer finds a nuchal cord wrapped securely (3 or 4 times
> circumferentially) and does not report this, they would be
>liable for
> censure if anything went wrong. Maybe the best outcome for your
>current
> difficulty would come from the referring physicians having a
>discussion with
> the sonographer in question and make them aware of their cocerns
>
> Cheers
>
> I absolutely agree......why is a sonographer telling the patient
>about the cord? Perhaps a policy should be put in place that the
>sonographer tells the doc about the cord, then leaves it up to the doc
>to tell the pt.
>
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--
art fougner, md
ich bin ein New Yorker
