Re: Incidental finding of sonolucency and partial abruption
From: candace (candacemhall@gmail.com)
Sun Jul 12 18:46:10 2009
Thank you, thank you, thank you!!!!!
These answers gave me much needed relief. The Dr.s I'm seeing were very
vague on what was going on and did not explain this half as well and
thourough as you. I was worrying that any little pain in my stomach was
going to send me to the er.
At Sun, 12 Jul 2009, jworrall@alaska.net wrote:
>
>Hi,
>
>I think you should not worry. A placental abruption is usually an acute and
>catastrophic event, usually in the setting of toxemia, hypertension, or some
>underlying problem. If you had a "partial abruption" two weeks ago it either
>became better or, more likely, it did not exist. Placental echolucencies are
>common and usually of no significance.
>
>However, if you are worried, and if you plan another scan about 6 weeks from
>the previous scan, and if there is a higher level of prenatal ultrasound
>available in your community, you might consider having the scan done at
>another location. For example, if you live in a large city with a big
>medical center, there may be an ultrasound laboratory there that specializes
>in obstetrics. If your 20 week scan were done by a general ob/gyn doctor in
>the office, there might be in your community a perinatologist or
>maternal-fetal medicine doctor (I am not sure what, if any, the difference
>is). Generally perinatologists or maternal-fetal medicine specialists are
>doctors who have had an ob/gyn residency and then take several additional
>years of training in high risk obstetrics. Generally they are the experts in
>prenatal sonography.
>
>Allen Worrall
>
>--------------------------------------------------
>From: "candace" <candacemhall@gmail.com>
>--------------------------------------------------
>--------------------------------------------------
>--------------------------------------------------
>Sent: Sunday, July 12, 2009 12:07 PM
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>To: "Multiple recipients of list ULTRASOUND" <ultrasound@mail.obgyn.net>
>--------------------------------------------------
>Subject: Re: Incidental finding of sonolucency and partial abruption
>--------------------------------------------------
>
>> Joseph,
>> I would be the patient in question. This is my fourth pregnancy with
>> three living children delivered to term. I am 28, very healthy, have
>> very normal ultrasound findings other that mentioned findings, do not or
>> have not smoked in this pregnancy. The ultrasound was done at my
>> regular 20 week scan.I have no previous bleeding in this pregnancy. I
>> am now almost 22 weeks with no other symptoms. The Dr. had told me
>> that it was a small area. He din't rule out a partial abruption. He
>> indicated it could be a placental lake, clotted blood for a partial
>> abrupto, or some other incidental finding. He indicated not to have sex
>> and repeat ultrasound in 4-6 weeks. I'm am basically just wanting to
>> know if this sounds like something that's going to progress into a
>> bigger problem, is this something that could or will resoulve on it's
>> own, or should I be worrying about abruption at this point. This is a
>> very serious complication of pregnancy and I'd like to know what I'm up
>> against if anything.
>> Thank you for your responce,
>> Candace H.
>>
>> At Sun, 12 Jul 2009, jworrall@alaska.net wrote:
>>>
>>>Dear Candace:
>>>
>>>There are a few more things that would be very helpful before we attempt
>>>to
>>>respond to your query. What is your relationship in this clinical
>>>situation?
>>>Are you the sonographer, the sonologist, the patient's obstetrical
>>>provider,
>>>the patient, the patient's mother etc? By knowing who you are we will have
>>>an idea of how to respond. Are we talking with an ultrasound professional
>>>seeking help? Are we talking with an obstetrician trying to understand an
>>>ultrasound report? Or are we talking with the patient or her friend or
>>>family?
>>>
>>>Secondly, we will need to know a good deal more about the patient: her
>>>age,
>>>BMI, gravity and parity, past medical history, past obstetrical history.
>>>Does she have chronic kidney disease? Does she have hypertension? If she
>>>smokes or did smoke cigarettes, how many per day for how many years? Is
>>>there a history of bleeding in this pregnancy?
>>>
>>>Where was the ultrasound done? Was it done in the obstetrician's office?
>>>Was
>>>it done in a general radiology department? Was it done in a setting that
>>>specializes in prenatal ultrasound? As in all things that humans do,
>>>expertise varies greatly in prenatal sonography, and depends on training,
>>>experience, specialization, interest, and the academic attitude of the
>>>department.
>>>
>>>Finally, it would be very helpful if you could include digital images of
>>>the
>>>ultrasound finding.
>>>
>>>If you are not the sonographer, not the sonologist, and not the
>>>obstetrical
>>>provider, then it is very likely that the sonologist and obstetrical
>>>provider directly involved with this patient's clinical situation are in a
>>>far better position to answer your question than any professional on the
>>>internet.
>>>
>>>I shall assume that you are NOT a medical professional involved with this
>>>case. I shall also assume that the patient is young, has no significant
>>>past
>>>medical or obstetrical history, has no significant history of smoking, and
>>>does not have hypertension or chronic kidney disease. It is unlikely the
>>>sonolucency you describe is of any significance. However, if the
>>>sonologist
>>>feels that placental abruption is present, that may be of significance and
>>>certainly your obstetrical provider should talk to you about that. A
>>>placental abruption in an otherwise healthy young patient would be
>>>unusual.
>>>Placental abruption can be very serious.
>>>
>>>Sincerely,
>>>
>>>Joseph A Worrall MD RDMS
>>>OB/GYN Ultrasound at the Fairbanks Clinic
>>>Fairbanks, Alaska, USA
>>>
>>>--------------------------------------------------
>>>From: "candace" <candacemhall@gmail.com>
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>>>--------------------------------------------------
>>>Sent: Sunday, July 12, 2009 10:20 AM
>>>--------------------------------------------------
>>>To: "Multiple recipients of list ULTRASOUND" <ultrasound@mail.obgyn.net>
>>>--------------------------------------------------
>>>--------------------------------------------------
>>>Subject: Incidental finding of sonolucency and partial abruption
>>>--------------------------------------------------
>>>
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>>>> Patient recieved an ultrasound at gestational age of 20 weeks. All
>>>--------------------------------------------------
>>>> findings were unremarkable except for a small sonolucent area at the
>>>> superior border of the placenta. Patient has not had any symptoms of a
>>>> partial abruption or complained of any contractions, pain, or bleeding.
>>>> The only finding was the sonolucent area. Question being, could this be
>>>> a healing clot from an earler time of gestation or beginning of
>>>> abruption. What would you think would be the outcome of this gestation.
>>>>
