Re: Nuchal cord
From: art fougner, md (evsono@pipeline.com)
Tue Jul 12 08:10:04 2005
Cases of nuchal cords with less than optimal outcomes often remind me of
those multiple choice questions - "True - True - But Unrelated."
art
At Tue, 12 Jul 2005, Latha Natarajan wrote:
>
>--Boundary_(ID_K3sTKhRuDjRtRDqXiuadng)
>Content-type: text/plain; charset=iso-8859-1
>Content-transfer-encoding: 7BIT
>
>OK, Thanks for this point - a systolic notch ?
>
>I had tried insonation at various points and so far I had not come across a notch.-
>
>Recently, we had a case of cord twice round the neck, a difficult slow vag. delivery. Baby was mildly pale and limp at birth , did well after due measures.
>
>About 6 hrs prior to delivery and during the early II stage of labour Umb. Arteries were interrogated with no abnormal wave forms. After sufficient drainage of Liq. couldn't get signals for obvious reasons..
>
>Towards the late II stage FH rate slowed down between contractions , slight mec. staining was noted. Hastened the delv. process, with an outlet forceps.
>
>I am of conclusion that clinical knowledge and experience comes handy knowing well the fallacies of u/s technology . ( My final points in debate as a measure of "escape" !! )- Am I justified in saying this ?
>
>LN.
>
>--------------------------------------------------------------------------------
>
>--------------------------------------------------------------------------------
>----- Original Message -----
>--------------------------------------------------------------------------------
>--------------------------------------------------------------------------------
>From: "art fougner, md" <evsono@pipeline.com>
>--------------------------------------------------------------------------------
>
>--
>--------------------------------------------------------------------------------
>To: "Multiple recipients of list ULTRASOUND" <ultrasound@dns.obgyn.net>
>--------------------------------------------------------------------------------
>Sent: Monday, July 11, 2005 10:34 PM
>--------------------------------------------------------------------------------
>Subject: Re: Nuchal cord
>
>> One suggestion from the AIUM meeting was to look at the umbilical artery
>> doppler - it appears that cord compression might be suspected by
>> notching in the artery waveform.
>>
>> art
>>
>> At Mon, 11 Jul 2005, Dave Berck wrote:
>> >
>> >problem is -- if you're also the obstetrician, you put the monkey on yourself, and let me tell you, my back's pretty crowded. I treat nuchal cords the same way as i treat incidental cardiac decelerations, isolated echogenic foci, and certain relatives -- I do my best to ignore them.
>> >
>> >Latha Natarajan <nattu@vsnl.com> wrote:Thanks Ibrahim.
>> >
>> >LN.
>> >
>
>>>> >>----- Original Message -----
>> >From: bouthina ibrahim To: Multiple recipients of list ULTRASOUND
>> >Sent: Sunday, July 10, 2005 10:30 AM
>> >Subject: Re: Nuchal cord
>> >
>> >we must examine fetal nect in transverse view and examine number of knots around fetal neckas it may cause fetal iugr
>> >"art fougner, md" <evsono@pipeline.com> wrote: No consensus presently -
>> >this topic has been discussed before ...
>> >try the search function and you'll find many diverse opinions.
>> >
>> >art
>> >
>> >At Sat, 9 Jul 2005, Latha Natarajan wrote:
>> >>
>> >>--Boundary_(ID_Os0C21aoRU8/92gmFAjv/Q)
>> >>Content-type: text/plain; charset=iso-8859-1
>> >>Content-transfer-encoding: 7BIT
>> >>
>> >>Dear friends,
>> >>
>> >>Is there a consensus on reporting of nuchal cord , esp. in the III Trimester ?
>> >>We have a debate on this topic next week.
>> >>
>> >>Any help on this topic will be appreciated.
>> >>Please give your inputs - personal experiences and view-points.
>> >>
>> >>Thanks,
>> >>LN.
>> >>Bangalore, India
>> >>
>> >>--Boundary_(ID_Os0C21aoRU8/92gmFAjv/Q)
>> >>Content-type: text/html; charset=iso-8859-1
>> >>Content-transfer-encoding: 7BIT
>> >>
>> >> Dear friends,
>> >
>> >> Is there a consensus
>> >>on reporting of nuchal cord , esp. in the
>> >>III Trimester ?
>> >
>> >> We have a debate
>> >>on this topic next week.
>> >
>> >> Any help on this topic
>> >>will be appreciated.
>> >
>> >> Please give your inputs - personal
>> >>experiences and view-points.
>> >
>> >> Thanks,
>> >
>> >> LN.
>> >
>> >> Bangalore, India
>> >
>> >>--Boundary_(ID_Os0C21aoRU8/92gmFAjv/Q)--
>> >
>> >--
>> >art fougner, md
>> >
>> >"If you don't know where you are going, you will wind up somewhere else."
>> >Lawrence Peter Berra
>> >
>> >David J. Berck, MD, MPH
>> >
>>
>> --
>> art fougner, md
>>
>> "If you don't know where you are going, you will wind up somewhere else."
>> Lawrence Peter Berra
>
>--Boundary_(ID_K3sTKhRuDjRtRDqXiuadng)
>Content-type: text/html; charset=iso-8859-1
>Content-transfer-encoding: 7BIT
>
><!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.0 Transitional//EN">
>
>OK, Thanks for this point - a
>systolic notch ?
>
>I had tried insonation at
>various points and so far I had not
>come across a notch.-
><FONT face=Verdana
>size=2>
>Recently, we had a case of cord
>twice round the neck, a difficult slow vag. delivery. Baby
>was mildly pale and limp at birth , did well after due
>measures.
>
>About 6 hrs prior to delivery and
>during the early II stage of labour Umb. Arteries were interrogated
>with no abnormal wave forms. After sufficient
>drainage of Liq. couldn't get signals for obvious
>reasons..
>
>Towards the late II stage FH
>rate slowed down between contractions , slight
>mec. staining was noted. Hastened the delv. process, with an
>outlet forceps.
>
>I am of conclusion
>that clinical knowledge and experience comes
>handy knowing well the fallacies of u/s
>technology . ( My final points in debate as a
>measure of "escape" !! )- Am I justified in saying
>this ?
>
>LN.
>
>>>----- Original Message -----
>From: "art fougner, md" <<A
>href="mailto:evsono@pipeline.com"><FONT face=Verdana
>size=2>evsono@pipeline.com>
>To: "Multiple recipients of list ULTRASOUND"
><<FONT face=Verdana
>size=2>ultrasound@dns.obgyn.net<FONT face=Verdana
>size=2>>
>Sent: Monday, July 11, 2005 10:34 PM
>Subject: Re: Nuchal cord
><FONT face=Verdana
>size=2>> One suggestion from the AIUM meeting was to look at the umbilical
>artery> doppler - it appears that cord compression might be suspected
>by> notching in the artery waveform.> > art>
>> At Mon, 11 Jul 2005, Dave Berck wrote:> >> >problem
>is -- if you're also the obstetrician, you put the monkey on yourself, and
>let me tell you, my back's pretty crowded. I treat nuchal cords the same way as
>i treat incidental cardiac decelerations, isolated echogenic foci, and certain
>relatives -- I do my best to ignore them.> >> >Latha
>Natarajan <<FONT face=Verdana
>size=2>nattu@vsnl.com> wrote:Thanks
>Ibrahim.> >> >LN.> >> >>-----
>Original Message -----> >From: bouthina ibrahim To: Multiple
>recipients of list ULTRASOUND> >Sent: Sunday, July 10, 2005 10:30
>AM> >Subject: Re: Nuchal cord> >> >we must examine
>fetal nect in transverse view and examine number of knots around fetal neckas it
>may cause fetal iugr> >"art fougner, md" <<A
>href="mailto:evsono@pipeline.com"><FONT face=Verdana
>size=2>evsono@pipeline.com> wrote: No
>consensus presently -> >this topic has been discussed before
>...> >try the search function and you'll find many diverse
>opinions.> >> >art> >> >At Sat, 9 Jul
>2005, Latha Natarajan wrote:> >>>
>>>--Boundary_(ID_Os0C21aoRU8/92gmFAjv/Q)> >>Content-type:
>text/plain; charset=iso-8859-1> >>Content-transfer-encoding:
>7BIT> >>> >>Dear friends,> >>>
>>>Is there a consensus on reporting of nuchal cord , esp. in the III
>Trimester ?> >>We have a debate on this topic next week.>
>>>> >>Any help on this topic will be appreciated.>
>>>Please give your inputs - personal experiences and view-points.>
>>>> >>Thanks,> >>LN.> >>Bangalore,
>India> >>>
>>>--Boundary_(ID_Os0C21aoRU8/92gmFAjv/Q)> >>Content-type:
>text/html; charset=iso-8859-1> >>Content-transfer-encoding:
>7BIT> >>> >> Dear friends,> >>
>>> Is there a consensus> >>on reporting of nuchal cord , esp.
>in the> >>III Trimester ?> >> >> We have a
>debate> >>on this topic next week.> >> >>
>Any help on this topic> >>will be appreciated.> >>
>>> Please give your inputs - personal> >>experiences and
>view-points.> >> >> Thanks,> >> >>
>LN.> >> >> Bangalore, India> >>
>>>--Boundary_(ID_Os0C21aoRU8/92gmFAjv/Q)--> >>
>>--> >art fougner, md> >> >"If you don't know
>where you are going, you will wind up somewhere else."> >Lawrence
>Peter Berra> >> >David J. Berck, MD, MPH>
>>> > --> art fougner, md> > "If you
>don't know where you are going, you will wind up somewhere else.">
>Lawrence Peter Berra
>
>--Boundary_(ID_K3sTKhRuDjRtRDqXiuadng)--
>
--
art fougner, md
"If you don't know where you are going, you will wind up somewhere else."
Lawrence Peter Berra
