Dear kanone,
Congratulations! The first thing to do is to relax and enjoy your
pregnancy - it goes by so fast and before you know it, you'll be
holding your little bundle in your arms. The most important thing you
can do now (for the health of your little one and your peace of mind)
is to have good communication between yourself and your doctor. If you
have any questions at all, you should be able to call your doctor (or
his/her assistant) on the phone and receive full answers to all of
your queries. That said, I can point you to a few websites that may
help you to understand some of the medical jargon, and in turn help
you to form questions for your next visit with your doctor.
I found an excellent article at The Hospital for Sick Children in
Toronto website, "Sonography of the Early First Trimester" by Shia
Salem, M.D.. Below are a few excerpts, however, I suggest you have a
look at the entire article (starts about a third of the way down the
page).
Regarding amnion - chorion separation, I don't think further testing
is indicated for now. Amniocentesis is usually performed between 16
and 18 weeks, if indicated, to determine if the baby has Down's
syndrome (I assume that is what you are concerned about).
"The amnion is a thin, rounded membrane that surrounds the embryo. In
turn, the amnion is completely surrounded by the thick, echogenic
chorion. The yolk sac is situated between the amnion and chorion. The
amnion develops at about the same time as the yolk sac (5 to 6 weeks).
However, because it is very thin, it is more difficult to visualize
and is seen only when it lies perpendicular to the ultrasound beam.
Unlike the yolk sac, the amnion grows rapidly during pregnancy. The
growing amniotic membrane begins to fuse with the chorionic membrane
by the middle of the first trimester and fusion is not complete until
at least the 12th week and often as late as the 16th week. By 16
weeks, the amnion has fused with the chorion, thus obliterating the
chorionic cavity. The chorionic cavity is more echogenic than the
amniotic cavity due to its thicker, stickier consistency. Sonographic
differentiation of the amnion and chorion is usually not difficult in
the first trimester, thus permitting the reliable determination of
amnionicity and chorionicity in multi-fetal pregnancies."
Regarding nuchal translucency:
"NT screening is a PROGRAM, not a measurement in isolation. If NT
screening is offered, it should be done so in the context of a
comprehensive program that offers:
* Pre-ultrasound counselling,
* Ultrasound by trained sonographers (with ultrasound quality
assurance program),
* Post-ultrasound counselling and risk-interpretation,
* Immediate access to genetic counselling and invasive testing if
an abnormality is detected, and
* Appropriate follow-up."
"Median NT measurements have been established for each gestational age
between 11 weeks to 13.6 weeks (CRL 45mm to 84mm)."
"... a normal ultrasound examination would substantially reduce her
age-related risk by approximately 50 percent (ie, 1:342 to 1: 686).
While this may be reassuring, she should be informed that ultrasound
may miss up to one in every three DS fetuses (about 1/3 of DS fetuses
will have a normal ultrasound examination).
For information on nuchal screening:
Fetal Medicine Foundation, Canadian Branch
The Fetal Centre at The Hospital for Sick Children
555 University Avenue, Toronto, Canada
Phone: (416) 813-8228
Fax: (416) 813-7880
Web site: http://www.hscFetalCentre.org
The Fetal Medicine Foundation UK
8 Devonshire Place
London, England
For information and course material:
Web site: http://www.fetalmedicine.com
The Hospital for Sick Children: Frontiers in Fetal Health
copyright 1999-2001 The Hospital for Sick Children
http://www.sickkids.on.ca/FrontiersinFetalHealth/FFHMarch2001.asp
In regards to your unicornuate uterus question, the separation is
probably not related, but that is one of the questions you can put on
your list for your doctor. There is such a wide variation of this
abnormality between women, that only your doctor could tell you for
sure.
1. What is a Unicornuate Uterus?:
http://www.dyspareunia.org/html/unicornuate_uterus.htm
2. Unicornuate Uterus
http://www.hystercity.com/unicornuate_uterus.htm
Additional Links:
bounty.com: nuchal translucency test:
http://www.your-pregnancy.co.uk/page16.asp
Placenta and Membranes
Explanation with drawings.
http://calloso.med.mun.ca/~tscott/embryo/emb5.htm
Search Strategy:
://www.google.com/search?q=amnion+chorion+translucency+scan&num=100&hl=en&lr=&ie=UTF-8&oe=UTF-8&as_qdr=all&sa=n&oq=amnion+chorion+translucency+sca
Terms Used:
amnion
chorion
translucency
scan
In closing, I would just like to say, please don't worry too much.
Stick to your regular routine (swimming should be fine, but ask your
doctor), and try to find a quiet time for yourself everyday that you
can sit down and sing a song for your baby or read to him/her. Doing
positive, pleasant things for your baby will make you (and your baby)
feel good - try not to spend too much time crunching numbers and
thinking about test results. The time will pass, whether you are
worrying or not.
Please ask for clarification if needed, before rating my answer. I've
tried my best to answer your questions, but truly only your doctor can
give you an informed complete picture (I hope I don't sound like a
broken record!).
Wishing you smooth sailing (apparently 1:639 is not a high risk
assessment)-
Sincerely,
hummer |
