Re: TTTS
From: Cheryl Turner (cheryl_norris@hotmail.com)
Thu May 5 11:01:29 2005
I'm with Dr. Philippe Jeanty's lab in Nashville, TN across the street from
Vanderbilt and we use Rubin Quintero in Tampa.
>From: "James Smeltzer" <James.Smeltzer@wellstar.org>
>Reply-To: ultrasound@obgyn.net
>To: Multiple recipients of list ULTRASOUND <ultrasound@dns.obgyn.net>
>Subject: TTTS
>Date: Thu, 5 May 2005 08:12:20 -0500
>
>Hi!
>
>Yesterday I saw a set of MC/DA female twins with one "stuck" but
>moving, mildly SGA and without CHF. Moderate (5%ile) cephalization. MCA
>Vmax 41 @ 23 weeks (Almost 1.5 MoM). Twin had ascites (large), LARGE MR
>and TR, but IVC waveform and DV waveforms were pretty good. Hydramnios
>but uterus soft and Cx 3.5 cm long and closed. Placenta was posterior.
>Both moving well.
>
>No anomalies other than ascites, cardiomegaly, MR, TR and a small
>pericardial effusion.
>
>By the ascites, hydramnios, MR and TR this is grade 4, but by twin
>appearance, behavior, cervix, & arterial and venous doppplers this was
>grade 1.
>
>When should I start to do amnioreduction? Who is doing ablations? Is
>there an NIH protocol? - Vanderbilt is reasonable distance and Tampa
>do-able from here.
>
>Thanks
>
>Jim Smeltzer
>
>James S. Smeltzer, MD, FACOG, SMFM
>Consultant, Maternal Fetal Medicine
>Wellstar Physicians' Group
>Northwest Women's Care
>787 Campbell Hill St
>Marietta GA 30060
>James.Smeltzer@wellstar.org
>VM 678-290-3035
>Off 770-528-0260
>Page 404-318-3451
>
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