ULTRASOUND Messages for August, 1998: Re: Perinatal statistics in YOUR country??

Re: Perinatal statistics in YOUR country??
From: James S Smeltzer MD (gaperina@mindspring.com)
Fri Aug 14 11:12:00 1998

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>From gaperina@mindspring.com Fri Aug 14 11:12:00 1998
Received: from camel8.mindspring.com (camel8.mindspring.com [207.69.200.58]) by talk.obgyn.net (8.8.8/8.8.8) with ESMTP id LAA20309 for <ultrasound@obgyn.net>; Fri, 14 Aug 1998 11:12:00 -0500 Received: from primary-ws (user-38lci70.dialup.mindspring.com [209.86.72.224]) by camel8.mindspring.com (8.8.5/8.8.5) with SMTP id MAA06981 for <ultrasound@obgyn.net>; Fri, 14 Aug 1998 12:12:00 -0400 (EDT) Message-Id: <3.0.1.32.19980814121921.006bd390@pop.mindspring.com> X-Sender: gaperina@pop.mindspring.com X-Mailer: Windows Eudora Light Version 3.0.1 (32) Date: Fri, 14 Aug 1998 12:19:21 -0400 To: ultrasound@obgyn.net From: James S Smeltzer MD <gaperina@mindspring.com> Subject: Re: Baby Coming In-Reply-To: <001d01bdc58f$eb110bc0$514795ce@jworrall.alaska.net> Mime-Version: 1.0 Content-Type: text/plain; charset="us-ascii"
Joseph,
I am in 100% accord with your position on adjusting risk, but our genetics colleagues say this should not be done. I say that the patient's information is the patient's property & they need to know it. Informing them of the adjusted risk is not the same as telling them they can not or should not have an amniocentesis. I thought AFP was a nuisance until we looked at the outcome data at our center & it was an eye-opener.
Jim Smeltzer (perinatal@perinatal.net)
At 08:24 PM 8/11/1998 -0500, you wrote: >Tom: Here in Fairbanks we charge $353 for 76805, but at 12 weeks I usually
>charge a limited 76816 @ $259. but if you bring your wife here I will do it
>for nothing!
>
>Jim has given an excellent presentation of the value of triple screening! I
>think your wife should get the screen. There is lots written about the
>California experience, where screening is mandatory. There are many false
>elevations, which lead to additional testing, but it is still worth while, I
>think.
>
>Regarding the ultrasound, do it your self. Do one now at 12 weeks so you can
>measure the nuchal translucency, and do another at 20 or 22 weeks. Or get
>one of your sonographer colleagues at work to do it for you, (for nothing)
>if you are not comfortable scanning your wife.
>
>Unrelated to Tom's situation:
>
>Jim brings up the question of the woman 35 or over who has a very low risk
>of aneuploidy on triple screen. Should she be asked to have an
>amniocentesis, with a risk of 1:300 or 1:250? If she has a GOOD ultrasound,
>and nothing abnormal is found, I am comfortable suggesting to these patients
>that perhaps they should not take the risk of amniocentesis, even though I
>think from a medicolegal standpoint, if she had a baby with aneuploidy, and
>took me to court, I probably would not be in a very good position.
>
>Joseph A Worrall MD RDMS
>

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