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Re: Yolk sac number in multiple gestations (monochorionic)From: Wolfgang Moroder, M.D. (wolfgang.moroder@tin.it)Thu Jun 24 15:07:30 2004
Dear Colleagues: I have been puzzled a lot by early sonoembryologic features. In the case presented by Rich Dempsey I should like to post the following comments: 1) I doubt that a cystic structure of 9 mm with absent heart pulsation, in a gestational sac of 5 weeks is compatible with an intact early pregnancy, 2) as shown in the following case that I published on OBGYN.net http://www.obgyn.net/us/gallery/OB_1_Normal_Monoamniotic_Twins.jpg http://www.obgyn.net/us/gallery/OB_1_Normal_Monoamniotic_Twins_Yolk_Sacs.jpg I have seen two early monoamniotic pregnancies with a yolk sac for each twin embryo, therefore even monoamniotic multiple pregnancies are associated with multiple yolk sacs, 3) early embryonic failure is often characterized by a disproportioned growth of the amniotic sac compared to the embryonic size, even if the embryo is still alive as you can observe in this videoclip: http://fetalmedicine.tripod.com/test.avi (allow the 1,1 MB avi clip to be downloaded). In this case you can observe a double cystic structure of different size, the major cyst being 8 mm. in diameter. A pulsating embryonic pole can be observed between them. It is difficult to distinguish in this case an overgrown amniotic sac from an oversized yolk sac. This was an early pregnancy failure. Please let us know the F/U and, why not, send us a picture. I'd welcome lots of comments. Wolfgang Moroder
At Wed, 23 Jun 2004, Rich Dempsey RDMS/RVT wrote:
>
-- Wolfgang Moroder, MD Prenatal Unit Bolzano General Hospital Italy
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