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Re: Abruptio placenta and ultrasound diagnosisFrom: Greg Kesby (gregkesby@optushome.com.au)Tue Jan 11 05:31:58 2005
Sometimes blood can be isoechoic with placenta and therefore the only sonographic hint you can have of an intraplacental/subplacental bleed is an abnormally thick placenta. Still ultrasound is not the way to diagnose abruption....it is a clinical diagnosis not a sonographic one. Only large abruptions can be considered sonographically evident and these are usually associated with a bradycardia.....and what are you doing a scan for when there is fetal bradycardia and presumably some pain..............you usually just get the baby out pronto....otherwise you have APGARS of 0.0.0. It is very unlikely you missed a large abruption at the time of your scan when placental views were unremarkeable and fetal heart rate normal.....there was either none present at that stage...or a very small one. Once again, ultrasound is not the way to diagnose abruption....it is a clinical diagnosis not a sonographic one. The diarrhoea may be coincidental.
-- Greg Kesby Fetal Medicine Sydney
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