Re: Abruptio placenta and ultrasound diagnosis
From: art fougner, md (evsono@pipeline.com)
Tue Jan 11 09:56:51 2005
Terry
sent you a pdf of the article referenced. if anyone else wants a copy,
feel free to email me off list.
art
At Tue, 11 Jan 2005, DuBose, Terry wrote:
>
>Did the article discuss the certifications, education, or experience of
>the sonographic operators? Seems that may make a difference in the
>outcomes.
>
>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
>
>Associate Professor & Director
>
>Diagnostic Medical Sonography Program
>
>University of Arkansas for Medical Sciences, CHRP
>
>4301 West Markham St. Mail Slot #563
>
>Little Rock, Arkansas, 72205 USA
>
>501-686-6510
>
>--
>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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--
art fougner, md
"If you don't know where you are going, you will wind up somewhere else."
Lawrence Peter Berra
