Nuchal Cord Redux
From: DR. JOE ANTONY (joeantony@HotPOP.com)
Thu Dec 30 20:43:04 2004
This is a very important observation.
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Joe.
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>----- Original Message -----
From: "art fougner, md" <evsono@pipeline.com>
To: "Multiple recipients of list ULTRASOUND" <ultrasound@dns.obgyn.net>
Sent: Thursday, December 30, 2004 9:20 PM
Subject: Re: Nuchal Cord Redux
> be careful about statements of 100% accuracy - thus far, i've never come
> across a medical test with a 100% predictive value - including the
> diagnosis of death. we still argue about the JFK autopsy. also, if you
> check out the authors' cv's, they do seem to be "good people", doubtless
> using "good equipment".
>
> Happy 2005
>
> art
>
> At Thu, 30 Dec 2004, Mario Libardi wrote:
> >
> >I agree 100% with Dr.Fazeel.
> >
> >Congrats
> >Mario Libardi, MD
> >Brasil
> >
> >> nuchal cord (presence or absence) detection rate should be
> >
> >100% in good
> >> hands and good machines with doppler.
> >>
> >> fazeel
> >>
> >> -------Original Message-------
> >>
> >> From: art fougner, mdDate: 12/29/04 18:19:12
> >> To: Multiple recipients of list ULTRASOUND
> >> Subject: Nuchal Cord Redux
> >>
> >> >From the White Journal Early View ( pre-release)...
> >>
> >> Ultrasound detection of nuchal cord prior to labor
> >
> >induction and the
> >> risk of Cesarean section
> >> E. Peregrine, P. O'Brien, E. Jauniaux
> >> Department of Obstetrics and Gynaecology, University
> >
> >College London
> >> Hospitals, London, UK
> >>
> >> Abstract
> >>
> >> Objectives
> >> To investigate the ability of ultrasound to detect the
> >
> >presence of a
> >> nuchal cord immediately prior to induction of labor and the
> >association
> >> of its presence with delivery by Cesarean section.
> >>
> >> Methods
> >> A transabdominal ultrasound scan using gray-scale and color
> >Doppler
> >> imaging was performed immediately prior to induction of
> >
> >labor in 289
> >> women in a prospective study to assess the presence of a
> >
> >nuchal cord.
> >> The presence of a nuchal cord was classified as present,
> >
> >absent or
> >> uncertain. The outcomes of labor, delivery and the neonates
> >were
> >> obtained from the patient notes after delivery.
> >>
> >> Results
> >> A nuchal cord was present at 18% of deliveries. The
> >
> >incidence was not
> >> affected by parity, fetal position or reduced amniotic
> >
> >fluid volume. The
> >> sensitivity of ultrasound in diagnosing a nuchal cord was
> >
> >37.5%, with
> >> specificity, positive and negative predictive values of
> >
> >80%, 29% and
> >> 85%, respectively. The presence of a nuchal cord did not
> >
> >significantly
> >> increase the risk of delivery by Cesarean section (35% vs.
> >
> >28%;
> >> relative risk = 1.22; 95% CI, 0.80-1.87), instrumental
> >
> >delivery for
> >> fetal distress, an abnormal cardiotocograph in labor or at
> >
> >delivery, an
> >> Apgar score < 7 at 1 min, arterial cord pH < 7.1 or
> >
> >neonatal unit
> >> admission.
> >>
> >> Conclusions
> >> The sensitivity of the ultrasound diagnosis of a nuchal
> >
> >cord is low
> >> prior to induction of labor at term. A nuchal cord does not
> >appear to
> >> increase the risk of Cesarean section or of poor neonatal
> >
> >outcome. The
> >> low ultrasound detection rate of a nuchal cord limits its
> >
> >use in
> >> decision making prior to induction of labor in high-risk
> >
> >pregnancies.
> >> Copyright © 2004 ISUOG. Published by John Wiley & Sons, Ltd.
> >>
> >> art
> >>
> >> --
> >> art fougner, md
> >> May the Joy of this Holiday Season Be with You
> >> and Yours throughout the New Year.
> >>
>
> >
>
> --
> art fougner, md
> May the Joy of this Holiday Season Be with You
> and Yours throughout the New Year.
