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Re: Yolk sacFrom: Joseph A Worrall MD RDMS (jworrall@alaska.net)Fri Jan 29 13:05:08 1999
1- Who should keep records?: Andrea, how about you being the record keeper? 2- How to measure? For the non-spherical yolk sacs, Mean Sac Diameter would be best, and that would be the mean of length, height, and width. So that we eliminate bias as to what constitutes a "non-spherical" yolk sac, it would be best if all yolk sacs were measured in three planes, and reported as MSDY (Mean Sac Diameter Yolk - to distinguish from the MSD of the gestational sac). HOWEVER - many would find having to take three measurements of the yolk sac a PITB (pain in the butt) and probably would not do it, so most likely we would be wise to just ask for an inner to inner measurement, and not worry about the data errors when the yolk sac is not spherical (You can tell already that I am not a trained scientist). Andrea, if you are serious about this, you will have to establish a YOLK SAC REGISTRY, and tell people what gestational age we should confine our measurements to, how to use email or OBGYN.NET to report the results, and most difficult, how to get follow-up on the pregnancy outcome. This would be a multicenter data collection, and the follow-up would be the most problematic. Regarding a post earlier today - I doubt that the yolk sac would ever have the specificity, sensitivity, and positive predictive value, that it could be used as a definitive indicator of aneuploidy. But maybe - that is why a huge study would be helpful. Is it possible to conduct such a study on the internet, internationally, and without Government grants of thousands of dollars or lira or whatever? I do not know, but I would be a willing participant. My guess is that there are enough dedicated sonographers that it might be possible. Probably the resulting study would have enough design faults and statistical problems, and biases, that it would not be considered a serious study, but it might indicate a trend to confirm studies that have already been done, such as Dr. Lyons' study. Joseph A Worrall MD RDMS
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