Re: new trends and approaches in biophysical profile
From: James S Smeltzer MD (gaperina@mindspring.com)
Wed Sep 8 23:06:59 1999
Terry & Al,
The "perfect" form of the BPP is still subject to argument, debate 7 even
scientific research. Are you taling about the Manning score or the Arabin
score (Or was that the SAFE score?).
A particular test is dreamed up by someone & then subjected to some tests -
or tested & then developed to fit the population. Hopefully it is tested
again. It can undergo modifications along the way. Babies with true
hydramnios (the clinical diagnosis of the nonpalpable or ballotable baby)
usually have trouble - more often than the slightly abnormal BPP that this
indication would cause. This is not an issue regarding the incompleteness
or invalidity of the BPP, as previously described and tested. It is only a
matter of the clinical importance of massive amniotic fluid we call
hydramnios.
By a similar argument: since IDMs with out of control mothers have a high
risk of asphyxial death in utero, they are like IUGR fetuses, which have
the same risk. Therefore we should describe babies with an AC above the
99%ile as IUGR, so we don't miss the risk of asphyxia that they have?!?!
Jim S;^|}>
At 11:09 AM 9/7/1999 -0500, you wrote:
>It does seem that polyhydramnios would be included in the BPP in some way.
>
>Terry J. DuBose, M.S., RDMS
>Director, Diagnostic Medical Sonography Program
>CHRP, University of Arkansas for Medical Sciences
>Little Rock, Arkansas, USA
>501-686-6510
>http://www.io.com/~dubose/ <http://www.io.com/~dubose/>
>http://www.uams.edu/CHRP/dmshome.htm <http://www.uams.edu/CHRP/dmshome.htm>
>
>http://www.obgyn.net/us/panel/panel.htm
><http://www.obgyn.net/us/panel/panel.htm>
>
> -----Original Message-----
> From: evsono@pipeline.com [SMTP:evsono@pipeline.com]
> Sent: Tuesday, September 07, 1999 10:57 AM
> To: Multiple recipients of list ULTRASOUND
> Subject: Re: new trends and approaches in biophysical profile
>
> Terry
>
> just got back from vacation. everyone knows that anomalies should
>be excluded with poly. the prob i am concerned with is the increased
>perinatal mortality and morbidity associated with poly, even in the absence
>of anomalies. yet all the "scoring systems" ignore this prob, focusing on
>oligo.
>
> perhaps Dr Platt has a comment concerning poly.
>
> Art
>
> At Thu, 26 Aug 1999, DuboseTerryJ@exchange.uams.edu wrote:
> >
> >A common concern in the presents of polyhydramnios is upper GI
>track problems that prevent swallowing. I had not thrown this out, but I
>noticed no one else said anything. So anomalies of the mouth (clefts),
>esophagus (tracheoesophageal fistulas), or esophageal atresias. Also
>neurologic problems that might affect the autonomic swallowing response.
> >
> >I am not sure about Polyhy as it relates to BPP.
> >
> >Terry J. DuBose, M.S., RDMS
> >Director, Diagnostic Medical Sonography Program
> >CHRP, University of Arkansas for Medical Sciences
> >Little Rock, Arkansas, USA
> >501-686-6510
> >http://www.io.com/~dubose/ <http://www.io.com/~dubose/>
> >http://www.uams.edu/CHRP/dmshome.htm
><http://www.uams.edu/CHRP/dmshome.htm>
> >
> >http://www.obgyn.net/us/panel/panel.htm
> ><http://www.obgyn.net/us/panel/panel.htm>
> >
> > -----Original Message-----
> > From: evsono@pipeline.com [SMTP:evsono@pipeline.com]
> > Sent: Thursday, August 26, 1999 12:36 PM
> > To: Multiple recipients of list ULTRASOUND
> > Subject: Re: new trends and approaches in biophysical
>profile
> >
> > Jim -
> >
> > ltns! problem with af volume assessment is that lit is
>divided. In july two articles suggested oligo might be less important yet
>another showed a significant import with borderline amt of af. also - as
>you suggest, the definition of oligo seems to vary from study to study.
>where is your reference on your work with cerebro - umbilical differences.
>Could not find this. and what about the significance of poly? should not
>the interpretation of bpp take the negative impact of poly into account? I
>have not found fetal breathing all that useful, especially in diabetics
>whose glucose seems to stimulate breathing. look forward to hearing from
>you.
> >
> > Art
> >
> > At Wed, 25 Aug 1999, James S Smeltzer MD wrote:
> > >
> > >Art,
>
