I think, unfortunately, that many without adequate experience or formal
education in sonography pay little attention to the hypoechoic
subplacental vascular bed. Attached is an image of a normal placenta
with the normal hypoechoic subplacental vascular bed demonstrated in the
fundus. The appearance may vary, especially if associated with a focal
contraction. There are also photos of the subplacental bed, some with
color Doppler, and discussion in DuBose: Fetal Sonography, W. B.
Saunders, 1996, p. 352-357.
Terry J. DuBose, M.S., RDMS, FSDMS, FAIUM
4301 West Markham St. Mail Slot #563
--
DuBoseTerryJ@UAMS.edu
http://www.io.com/~dubose/
http://www.uams.edu/chrp/dms/default.asp
http://www.obgyn.net/us/panel/panel.htm
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-----Original Message-----
From: ultrasound@obgyn.net [mailto:ultrasound@obgyn.net] On Behalf Of
art fougner, md
Sent: Tuesday, January 11, 2005 7:33 AM
To: Multiple recipients of list ULTRASOUND
Subject: Re: Abruptio placenta and ultrasound diagnosis
>From :J Ultrasound Med. 2002 Aug;21(8):837-40.
Clinical utility of sonography in the diagnosis and treatment of
placental abruption.
Glantz C, Purnell L.
Of 55 patients who gave birth within 14 days of sonography, 8 (15%) had
scans consistent with abruption, and 29 (53%) had abruption at delivery;
the sensitivity, specificity, and positive and negative predictive
values of sonography were 24%, 96%, 88%, and 53%, respectively.
Positive
sonographic findings were univariately associated with 2- to 3-fold
greater subsequent tocolysis, betamethasone use, duration of
hospitalization, follow-up sonograms, preterm delivery, low birth
weight, and neonatal intensive care unit admission. All but low birth
weight and neonatal intensive care unit admission remained independently
significant after adjustment for gestational age (P < .05).
CONCLUSIONS:
Sonography is not sensitive for detection of placental abruption, but a
positive finding is associated with more aggressive management and worse
neonatal outcome.
art
At Tue, 11 Jan 2005, Raul Limos wrote:
>
>I had a service patient who had a routine obstectric scan about 6 days
>ago and everything was normal and came to the hospital yesterday for
>bouts of diarrhea. The resident obstetrician checked the baby for
>fetal well being and the baby had fetal bradycardia. On emergency
>c-section they found out that there was an abruption placenta of about
>50%. The APGAR Score of the baby was 0 and presently
On ventilator.
>
>My question is did I miss the abruptio or the diarrhea precipitated
>this event? I am trying to retrieve the films we took from the patient
>for review as we routinely take pictures of the placenta.
--
art fougner, md
"If you don't know where you are going, you will wind up somewhere
else."
Lawrence Peter Berra
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