Re: Does hypochorionic hemorrhage alters triplo-test results?'reply'
From: art fougner, md (evsono@pipeline.com)
Sat Apr 3 11:32:51 2004
along similar lines, i've noticed a trend in abnormal maternal serum
screens, especially high afp's, associated with multifetal reduction
procedures. anecdotal though, not evidence-based.
art
At Fri, 02 Apr 2004, Latha Natarajan wrote:
>
>Maternal Serum AFP levels go up with haemorrhage.
>
>LN.
>
>>>----- Original Message -----
>From: "art fougner, md" <evsono@pipeline.com>
>To: "Multiple recipients of list ULTRASOUND" <ultrasound@dns.obgyn.net>
>Sent: Friday, April 02, 2004 12:19 AM
>Subject: Re: Does hypochorionic hemorrhage alters triplo-test
>results?'reply'
>
>> But how were the maternal serum screens specifically affected by
>> "threatened miscarriage"?
>>
>> art
>>
>> At Wed, 31 Mar 2004, AFPPLUS3@aol.com wrote:
>> >
>> >This may help you with regards to adjusting the patients risk...
>> >
>> >Threatened abortion: A risk factor for poor pregnancy outcome, a
>> >population-based screening study
>> >Joshua L. Weiss, MD,* Fergal D. Malone, MD, John Vidaver, MA, Robert H.
>Bal ,
>> >MD,
>> >David A. Nyberg, MD, Christine H. Comstock, MD, Gary D. Hankins, MD,
>Richar
>> >L. Berkowitz, MD, Susan J. Gross, MD, Lorraine Dugoff, MD, Ilan E.
>> >Timor-Tritsch, MD, Mary E. Dâ?TAlton, MD, for the FASTER Consortium
>> >Columbia Presbyterian Medical Center, New York, NY
>> >â?"
>> >Objective: The purpose of this study was to determine whether patients
>with
>> >first-trimester threatened abortion are at increased risk for poor
>pregnanc
>> >outcome.
>> >Study design: A large prospective multicenter database was studied.
>Subject
>> >were divided into three groups: (1) no bleeding, (2) light bleeding, and
>(3
>> >heavy bleeding. Univariate and multivariable logistic regression analyses
>w re
>> >used.
>> >Results: The study comprised 16,506 patients: 14,160 patients without
>> >bleeding, 2094 patients with light bleeding, and 252 patients with heavy
>bl eding.
>> >Patients with vaginal bleeding, light or heavy, were more likely to
>experie ce a
>> >spontaneous loss before 24 weeks of gestation (odds ratio, 2.5 and 4.2,
>> >respectively) and cesarean delivery (odds ratio, 1.1 and 1.4,
>respectively) Light
>> >bleeding subjects were more likely to have preeclampsia (odds ratio,
>1.5),
>> >preterm delivery (odds ratio, 1.3), and placental abruption (odds ratio,
>1. ).
>> >Heavy vaginal bleeding subjects were more likely to have intrauterine
>growt
>> >restriction (odds ratio, 2.6), preterm delivery (odds ratio, 3.0),
>preterm
>> >premature rupture of membranes (odds ratio, 3.2), and placental abruption
>( dds
>> >ratio, 3.6).
>> >Conclusion: First-trimester vaginal bleeding is an independent risk
>factor
>> >for adverse obstetric outcome that is directly proportional to the amount
>o
>> >bleeding.
>> > 2004 Elsevier Inc. All rights reserved.
>> >KEY WORDS
>> >Threatened abortion
>> >Spontaneous pregnancy
>> >loss
>> >Preterm delivery
>> >Placental abruption
>> >Preterm premature
>> >rupture of membranes
>> >â?"
>> >First-trimester vaginal bleeding is a common complication that affects
>16% o
>> >25% of all pregnancies.1,2 When pregnant patients have bleeding, it may
>cau e
>> >stress and anxiety for the mother-to-be about the future outcome of the
>> >pregnancy. In general, the incidence of
>> >spontaneous abortion after first-trimester bleeding is quoted to be 50%
>> >before sonographic evaluation for fetal viability.1,3 If a viable fetus
>is oted at
>> >ultrasound examination after first-trimester vaginal bleeding, 95% to 98%
>o
>> >such pregnancies will still continue beyond 20
>> >weeks of gestation.1,4 Supported by grant No. RO1 HD 38652 from the
>National
>> >Institutes of Health and the National Institute of Child Health and Human
>> >Development.
>> >* Reprint requests: Joshua L. Weiss, MD, Columbia Presbyterian
>> >Medical Center, 622 W 168th St, PH-16-66, New York, NY 10032.
>> >E-mail: jw791@columbia.edu
>> >http://www.elsevier.com/locate/ajog
>> >
>> >American Journal of Obstetrics and Gynecology (2004) 190, 745-50
>> >
>> >Leonard H. Kellner
>> >Lenetix Medical Screening Laboratory, Inc.
>> >
>> >CONFIDENTIALITY NOTICE: This email contains information from the sender
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>> --
>> art fougner, md
>> ich bin ein New Yorker
--
art fougner, md
ich bin ein New Yorker
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