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Re: cerebral dopplerFrom: James S Smeltzer MD (gaperina@mindspring.com)Mon Aug 31 05:34:08 1998
Hi Claudio, As you are, I am very satisfied with the comparison of the MCA RI to the Umbilical as a gestational age independent index of fetal reserve after 24 weeks. I have used this for a decade with only one fetal loss. This was actually predicted as decreased reserve by the doppler, and the patient abrupted at the mall when home on bed rest last week. Those who do not use this simple assessment lack the knowledge or the equipment, IMHO. The literature is quite good. The only problem is that the method does not predict which will develop problems - just which babies have less reserve if problems are encountered. Remember that what you see is adaptive accomodation to a less friendly environment - or also the increased cortical activity of awake state, which look the same, and that the fetus in extremis will have normal cerebral dopplers (but also likely AEDV of umbilical from fetal shock). In short, continue to use your method, and do not worry too much about ignorant Americans & what they do & do not do. Jim Smeltzer MD (perinatal@perinatal.net)
At 07:38 PM 8/27/1998 -0500, you wrote:
>I had difficult to understood the laqnguage, but, if im correct you and the
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