ULTRASOUND Messages for January, 2005: Re: Abruptio placenta and ultrasound diagnosis

Re: Abruptio placenta and ultrasound diagnosis
From: DuBose, Terry (DuboseTerryJ@uams.edu)
Tue Jan 11 11:51:23 2005

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Here at UAMS we use the ALI PACS. The machines are connected through the university LAN to a central server with a large "Jukebox" of magnetoptical disks. While we use the ALI system, I have no other financial connection with them... for more info see: http://www.mckesson.com/releases/2002/070802_221890159.htm
We can save JPG or TIFF static images, or short video clips to the server. The system also accommodates teaching files for the faculty. It is not perfect, but works. Sonographers on the system can call a physician at another site and they can both look and discuss the case. The images only exist as digital images, and the quality for lectures is as good as the original.
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 ---------------------------------------------------------------

--------------------------------------------------------------- -----Original Message----- --------------------------------------------------------------- From: ultrasound@obgyn.net [mailto:ultrasound@obgyn.net] On Behalf Of Brooke Cregor Sent: Tuesday, January 11, 2005 10:52 AM To: Multiple recipients of list ULTRASOUND Subject: Re: Abruptio placenta and ultrasound diagnosis
Terry,
Please let me know how you are digitizing these ultrasound images so that you can send them via email. Are these images scanned in or are you using a device that connects directly to your ultrasound machine that automatically converts the images to jpg, dicom, bmp? I am curious as the MediCapture unit from http://www.medicapture.com <http://www.medicapture.com/> seems to be a nice cost effective solution. We are looking into it as a solution now, but would really like to get real users feedback on the usability. I am just curious if you are using it and have any feedback on it's use.
It seems like a simple device designed with the sonographer in mind. One big plus was that it seemed to be featured on the July 04 cover page of OR today http://www.mdpublishing.com/ORToday/CorpProfiles/04/Jul.htm
Regards,
Brooke
________________________________
From: ultrasound@obgyn.net [mailto:ultrasound@obgyn.net] On Behalf Of
-- ________________________________ DuBose, Terry Sent: Tuesday, January 11, 2005 10:14 AM To: Multiple recipients of list ULTRASOUND Subject: Re: Abruptio placenta and ultrasound diagnosis
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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