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Re: Developing Accreta From: art fougner, md (evsono@pipeline.com) Mon Aug 24 07:37:20 1998 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Joseph Allen Worrall Jr.: "shelf" Previous message: James S Smeltzer MD: "Re: Developing Accreta" In reply to: James S Smeltzer MD: "Re: Developing Accreta" Next in thread: James S Smeltzer MD: "Re: Developing Accreta" Reply: James S Smeltzer MD: "Re: Developing Accreta" Jim, look at it this way - the U/S is a screen. if you feel that the images suggest a high risk for percreta or even increta for that matter, why not get a targeted MRI? additionally, if bladder involvement is suspected, then a cysto would shed more light i suspect. fortunately, these cases are usually few and far between but it does pay to have some additional diagnostic modalities for the tough cases. btw in our case posted awhile back, the patient's OB punted to the hospital which quite predictably took over all aspects of the case. sad to say, i have no more input and can't even obtain follow-up images. i will post the outcome, however. Art At Mon, 24 Aug 1998, James S Smeltzer MD wrote: > >At 02:44 PM 8/22/1998 -0500, you wrote: >> Did not come thru but q was detectability of percreta. > >Hi Martin, > >In my 15 years of prenatal diagnosis I have been singularly unimpressed >with my and my peers' ability to perform this simple task. > >A patient scanned at a leading sonography center came into our ER DOA >because of a percreta which was not detected or detectable by a 16 week >scan done there. I have thought I had percreta on multiple occasions to >find that I did not. > >Others have been through the same thing. > >I had an increta which was extensive that was manifested by a second stage >arrest in a 20 week miscarriage, and by numerous flame-like lakes in the >placenta (Base to surface & ramified). I did not recognize that as a >manifestation at the time. This patient died of this cause after delivery. > I have subsequently seen this four times & three had accreta, two lost >uterus, two preterm & one normal outcome. > >This is humbling, as I approach every problem of pregnancy as diagnosable >by US until proven otherwise. Why do you ask? Jim Smeltzer MD >(perinatal@perinatal.net) -- art fougner, md SonoScan/Genetic Sciences forest hills, ny evsono@pipeline.com Next message: Joseph Allen Worrall Jr.: "shelf" Previous message: James S Smeltzer MD: "Re: Developing Accreta" In reply to: James S Smeltzer MD: "Re: Developing Accreta" Next in thread: James S Smeltzer MD: "Re: Developing Accreta" Reply: James S Smeltzer MD: "Re: Developing Accreta"

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