Evaluation and Follow-up of Fetal Hydronephrosis

Save this PDF as:

Size: px
Start display at page:

Download "Evaluation and Follow-up of Fetal Hydronephrosis"

Transcription

1 Evaluation and Follow-up of Fetal Hydronephrosis Deborah M. Feldman, MD, Marvalyn DeCambre, MD, Erin Kong, Adam Borgida, MD, Mujgan Jamil, MBBS, Patrick McKenna, MD, James F. X. Egan, MD Objective. To determine the antenatal course and neonatal follow-up of isolated fetal hydronephrosis. Methods. We reviewed our ultrasonography database from January 1989 to June 1999 for all cases of unilateral or bilateral fetal hydronephrosis that had at least 1 follow-up ultrasonographic examination. Cases were defined as mild, moderate, or severe depending on the renal pelvis anteroposterior diameter and gestational age. Data were analyzed using the χ 2 test with the Fisher exact test where appropriate. Medical records were reviewed, and telephone interviews were performed to determine which infants received follow-up after birth. Results. Of 57,966 ultrasonographic examinations in 20,049 women during the study period, 393 patients met criteria for evaluation. Of these, 347 (88%) had fetuses with mild hydronephrosis. Most of these had complete resolution during the pregnancy. Forty patients had fetuses classified as having moderate hydronephrosis, and 6 patients had fetuses with severe hydronephrosis. Of those classified as moderate hydronephrosis, 15% resolved, 25% improved, 48% remained unchanged, and 12% worsened during the pregnancy. There were no cases of in utero resolution in the severe group; however, 4 of 6 cases improved to moderate or mild, and 2 cases remained unchanged. Of the cases identified prenatally, 25 received consultation by a pediatric urologist in the newborn period, and 7 of these required surgical intervention. Conclusions. Our population-based data suggest that most cases of mild hydronephrosis will resolve before delivery. In contrast, cases of moderate or severe hydronephrosis are less likely to have resolution in utero and are more likely to worsen or remain unchanged. Of those fetuses with persistent hydronephrosis, only a small number required some surgical intervention after birth. This information is useful in counseling the patient whose fetus is noted to have isolated hydronephrosis. Key words: fetal hydronephrosis; prenatal ultrasonography; pregnancy. Abbreviations AP, anteroposterior Received October 30, 2000, from the Division of Maternal-Fetal Medicine, University of Connecticut Health Center, Farmington, Connecticut (D.M.F., A.B., J.F.X.E.); Saint Francis Hospital and Medical Center (E.K., A.B., M.J., J.F.X.E.) and Division of Urology, Connecticut Children s Medical Center (M.D.), Hartford, Connecticut; and Southern Illinois University, Springfield, Illinois (P.M.). Revision requested November 27, Revised manuscript accepted for publication May 21, Address correspondence and reprint requests to Deborah M. Feldman, MD, Division of Maternal- Fetal Medicine, Department of Obstetrics and Gynecology, University of Connecticut Health Center, MC-2950, Farmington, CT Fetal urinary tract abnormalities are among the most commonly diagnosed prenatal malformations, with a reported prevalence as high as 1 per 100 pregnancies. 1 The routine use of prenatal ultrasonography has led to an increase in the number of fetuses identified with urologic anomalies. The benefit is that these infants may be followed in the neonatal period for definitive diagnosis and treatment if necessary. Several studies have been published that attempt to establish a correlation between fetal hydronephrosis and neonatal outcome. 2 7 Limitations of many of these reports include inconsistent definitions of hydronephrosis as well as follow-up information of only those neonates who required surgery after delivery. In 1990, Mandell 8 published a classification system for the prenatal diagnosis of fetal hydronephrosis based on renal pelvis anteroposterior (AP) diameter and gestation by the American Institute of Ultrasound in Medicine J Ultrasound Med 20: , /01/$3.50

2 Evaluation and Follow-up of Fetal Hydronephrosis al age. At 15 to 20 weeks gestation, those fetuses with renal AP diameters of 4 to 7 mm are considered to have mild hydronephrosis, and those with AP diameters greater than 7 mm are classified as having moderate hydronephrosis. At more than 20 to 30 weeks gestation (Fig. 1), renal AP diameter may have mild (5 8 mm), moderate (9 15 mm), or severe (>15 mm) dilatation. Finally, at a gestational age of more than 30 weeks to term, the values increase slightly to 7 to 9 mm for mild, 10 to 15 mm for moderate, and 16 mm or greater for severe. Since the initial presentation of these data, patients evaluated at Saint Francis Hospital and Medical Center who have a diagnosis of fetal hydronephrosis based on prenatal ultrasonography are classified as mild, moderate, or severe according to the criteria of Mandell. 8 Because of the lack of consensus on the treatment during pregnancy of patients with fetal hydronephrosis, our aim in this study was to determine the antenatal course of those patients whose fetuses had a diagnosis of isolated hydronephrosis on the basis of the criteria of Mandell. 8 Specifically, we sought to determine the natural course of mild fetal hydronephrosis with the future goal of developing a protocol for follow-up of these patients during the pregnancy. In addition, we sought to evaluate the number of neonates who received any type of follow-up after birth. Figure 1. Unilateral mild hydronephrosis at 30 weeks gestation. Arrow indicates left renal pelvis. Materials and Methods We performed a retrospective review of our computerized ultrasonography database at Saint Francis Hospital and Medical Center, a tertiarylevel community hospital performing approximately 3300 deliveries annually. The study period was between January 1989 and June The database was initially searched for all renal anomalies. Patients were then included in the study if they had documented unilateral or bilateral fetal hydronephrosis, if they had at least 1 follow-up ultrasonographic examination after the initial ultrasonography, and if they had planned to have delivery at our institution. Excluded from the study were multiple gestations or fetuses with other known structural or chromosomal anomalies. Also excluded were those patients with other genitourinary abnormalities involving the bladder, ureter, or architecture of the kidney. Cases were classified as mild, moderate, or severe hydronephrosis on the basis of the findings of their initial ultrasonographic examinations using the classification criteria of Mandell. 8 These findings were compared with subsequent ultrasonographic findings to determine whether the hydronephrosis had resolved or whether the classification had remained the same or changed (improved or worsened) during the pregnancy. Statistical analysis was performed using the χ 2 test with the Fisher exact test where appropriate, with P <.05 considered significant. To obtain neonatal follow-up data, we reviewed records from the Department of Pediatric Urology at Connecticut Children s Medical Center, which is the only referral center in the region. Those patients who had persistent hydronephrosis at the time of their last ultrasonography but whose children did not receive consultation or treatment at this center were telephoned by the investigators to determine whether follow-up was performed elsewhere. Results A total of 57,966 ultrasonographic examinations were performed on 20,049 women during the study period. Of these, 393 (2%) met criteria for inclusion in the study. The antenatal courses of all 393 patients are summarized in Table 1. Most fetuses identified with hydronephrosis were classified as having unilateral or bilateral mild hydronephrosis at initial ultrasonography 1066 J Ultrasound Med 20: , 2001

3 Feldman et al Table 1. Summary of the Antenatal Course of 393 Patients With Fetal Hydronephrosis Classification Total, n (%) Resolved, n (%) Improved, n (%) Unchanged, n (%) Worsened, n (%) Mild 347 (88.3) 178 (51)* 0 (0) 134 (39) 35 (10) Moderate 40 (10.2) 6 (15) 10 (25) 19 (48) 5 (12) Severe 6 (1.5) 0 (0) 4 (67) 2 (33) (0) *P <.001 when compared with resolution of moderate or severe hydronephrosis. (347 [88%]). Of these, 51% resolved completely, 39% remained unchanged, and 10% worsened before delivery. Figures 2 and 3 illustrate the antepartum courses of unilateral and bilateral mild fetal hydronephrosis, respectively. There were 40 fetuses identified with moderate unilateral or bilateral hydronephrosis (10%) at initial ultrasonography. Only 6 (15%) of these cases resolved before delivery, whereas 10 (25%) improved to the mild classification, 19 (48%) remained unchanged, and 5 (12%) worsened to severe. Six cases of severe hydronephrosis were identified; none had in utero resolution. Four of the 6 cases improved to moderate or mild, and 2 cases remained unchanged throughout the pregnancy. When compared with cases of moderate or severe hydronephrosis, mild cases were more likely to have resolution in utero (P <.001). Of the 347 fetuses identified with mild hydronephrosis, 221 were found to have unilateral hydronephrosis, and 126 had bilateral hydronephrosis. In evaluating the antenatal courses of those with unilateral hydronephrosis, 113 cases (51.2%) had complete resolution, 84 (37.7%) remained the same, and 24 (10.6%) worsened to the moderate or severe classification at some point during the pregnancy. Of the 126 fetuses identified with bilateral hydronephrosis, 64 (50.8%) had complete resolution, whereas 50 (39.8%) remained the same and 12 (9.3%) worsened. The differences in the rates of resolution among those with unilateral versus bilateral mild hydronephrosis were not statistically significant. Of the 40 cases of moderate hydronephrosis, 15 (37.5%) were unilateral and 25 (67.5%) were bilateral. Follow-up data on the cases of unilateral moderate hydronephrosis revealed resolution in 1 case (6.7%), improvement to mild in 5 (33.3%), no change in 8 (53.3%), and worsening to severe in 1 (6.7%). Of the 25 cases of bilateral moderate hydronephrosis, 5 cases (20%) resolved, 5 (20%) improved to mild, 11 did not change (44%), and 4 worsened (16%). Cases of bilateral moderate hydronephrosis were significantly more likely to resolve than cases of unilateral moderate hydronephrosis (P <.05). There were no cases of in utero intervention among any patients in the study group. Neonatal follow-up data were available after 1996, at which point the referral network to the Pediatric Urology Division was well established. There were 110 cases of persistent hydronephrosis identified from 1996 to Of these, we were able to identify 25 (23%) patients who received consultation or treatment by a pediatric urologist in the newborn period. Follow-up data were available on these patients for up to 6 years. Table 2 summarizes the diagnoses and outcomes of these patients. Seven of these patients required surgery, including ureteropelvic junction obstruction repair in Figure 2. Outcomes of 221 cases of unilateral mild hydronephrosis. Figure 3. Outcomes of 126 cases of bilateral mild hydronephrosis. J Ultrasound Med 20: ,

4 Evaluation and Follow-up of Fetal Hydronephrosis Table 2. Summary of 25 Cases of Pediatric Urologic Follow-up No. of Diagnosis* Cases Surgery Outcome Follow-up, y Hydronephrosis 10 0/10 5 resolved, improved, 2 stable Reflux 5 2/5 2 resolved, improved Ureteropelvic junction 6 5/6 6 resolved 2 3 obstruction Duplication 2 0/2 1 resolved, improved Megaureter 2 0/2 2 resolved 2 3 *Primary diagnosis for neonate. 5 patients and nephrectomy in 2. There was no significant association between the need for surgery and the severity of hydronephrosis at the last ultrasonographic examination (P =.32) or whether the hydronephrosis worsened during the pregnancy (P =.65). Of the 7 cases requiring surgery, 5 were identified as mild hydronephrosis, and 2 were identified as severe at initial ultrasonography. Four of the mild cases worsened to moderate hydronephrosis, and 1 remained mild. The 2 severe cases remained unchanged throughout the pregnancies. Of the remaining 85 patients whose newborns did not receive consultation or treatment with a pediatric urologist at our referral center, 36 (42%) were reached by telephone, and followup information was completed. By patient report, neonatal renal ultrasonography was performed on an outpatient basis in 19 cases, with normal results reported in 16 cases and mild hydronephrosis, which was followed by a pediatric nephrologist, in 3 cases. Seventeen patients received no neonatal follow-up according to our telephone survey. In all of these cases, parents reported that the children were healthy with no known medical problems. Discussion Prenatal ultrasonographic detection of a fluid collection in the fetal renal pelvis can often represent a diagnostic dilemma for the obstetrician and may well lead to unnecessary parental anxiety. In many cases, however, there is a major benefit to alerting the pediatrician and pediatric urologist of a possible fetal urologic malformation so that early postnatal evaluation and treatment can be initiated. Although several ultrasonographic diagnostic criteria have been proposed for the detection of fetal hydronephrosis, 7,9 there is no established universal definition. In addition, although many investigators use the renal pelvic AP diameter as the primary technique for diagnosing fetal hydronehprosis, 7,9,10 others have suggested that the ratio of AP pelvic diameter to AP kidney diameter may be helpful. 10,11 Again, no universally accepted cutoff values of these measurements have been established. The classification system established by Mandell 8 considers the normal growth that occurs in the fetal kidney as gestational age advances, thereby establishing different threshold values at different gestational ages. Although it is widely accepted that a fetal renal pelvic AP diameter of greater than 10 mm is abnormal at any gestational age, setting a lower threshold earlier in gestation may allow for earlier detection of a potential genitourinary anomaly and may allow for appropriate antenatal monitoring. The data we present, using the sonographic classification system of Mandell, 8 indicate that 51% of fetuses with unilateral or bilateral mild hydronephrosis are likely to have complete resolution before delivery, possibly eliminating the need for a postnatal evaluation of the infant. However, because of the small (10%) chance of worsening hydronephrosis, we recommend follow-up ultrasonography before delivery with appropriate postnatal follow-up if needed. Fetuses with moderate or severe hydronephrosis on the basis of this classification system are significantly less likely to undergo resolution. They should be followed antenatally for worsening hydronephrosis, and if the hydronephrosis is associated with oligohydramnios, possible antenatal intervention could be considered. Postnatally, these patients should receive a urologic evaluation. The retrospective nature of this study did not allow us to report on the neonatal outcomes of all the study patients; however, we were able to report on the patients who did receive care at our pediatric urology referral center as well as many patients who received only outpatient follow-up neonatal renal ultrasonography. To obtain more complete outcome data on all patients with the diagnosis of prenatal hydronephrosis, a prospective cohort study is needed J Ultrasound Med 20: , 2001

5 Feldman et al References 1. Elder JS. Antenatal hydronephrosis: fetal and neonatal management. Pediatr Clin North Am 1997; 44: Stocks A, Richards D, Frentzen B, Richard G. Correlation of prenatal renal pelvic anteroposterior diameter with outcome in infancy. J Urol 1996; 155: Barker P, Cave MM, Thomas DFM, et al. Fetal pelviureteric junction obstruction: predictors of outcome. Br J Urol 1995;76: Najmaldin AS, Burge DM, Atwell, JD. Outcome of antenatally diagnosed pelviureteric junction hydronephrosis. Br J Urol 1991; 67: Clautice-Engle T, Anderson NG, Allan RB, Abbott GD. Diagnosis of obstructive hydronephrosis in infants: comparison sonograms performed at 6 days and 6 weeks after birth. AJR Am J Roentgenol 1995; 163: Arnold AJ, Rickwood AMK. Natural history of pelviureteric obstruction detected by prenatal sonography. Br J Urol 1990; 65: Corteville JE, Gray DL, Crane, JP. Congenital hydronephrosis: correlation of fetal ultrasonographic findings with infant outcome. Am J Obstet Gynecol 1991; 165: Mandell J. Prenatal diagnosis and treatment of obstructive uropathies. Probl Urol 1990; 4: Grignon A, Filion R, Filiatrault D, et al. Urinary tract dilation in utero: classification and clinical applications. Radiology 1986; 160: Arger PH, Coleman BG, Mintz MC, et al. Routine fetal genitourinary tract screening. Radiology 1985; 156: Kleiner B, Callen PW, Filly RA. Sonographic analysis of the fetus with ureteropelvic junction obstruction. AJR Am J Roentgenol 1987; 148: J Ultrasound Med 20: ,

Assessment and Management of Fetal Hydronephrosis

Assessment and Management of Fetal Hydronephrosis Article urology Assessment and Management of Fetal Hydronephrosis William A. Kennedy II, MD* Objectives After completing this article, the reader should be able to: 1. Differentiate genitourinary abnormalities

More information

Maternity Renal Pelvis Dilation (RPD)

Maternity Renal Pelvis Dilation (RPD) Maternity Renal Pelvis Dilation (RPD) Fetal Medicine Unit Your baby has been found to have more fluid in its kidneys than normal. This leaflet will explain what this means for your baby. First of all,

More information

Fetal Prognosis in Varix of the Intrafetal Umbilical Vein

Fetal Prognosis in Varix of the Intrafetal Umbilical Vein Fetal Prognosis in Varix of the Intrafetal Umbilical Vein Waldo Sepulveda, MD, Antonio Mackenna, MD, Jorge Sanchez, MD, Edgardo Corral, MD, Eduardo Carstens, MD To assess the clinical significance of varix

More information

echocardiography practice and try to determine the ability of each primary indication to identify congenital heart disease. Patients and Methods

echocardiography practice and try to determine the ability of each primary indication to identify congenital heart disease. Patients and Methods 29 ABNORMAL CARDIAC FINDINGS IN PRENATAL SONOGRAPHIC EXAMINATION: AN IMPORTANT INDICATION FOR FETAL ECHOCARDIOGRAPHY? RIMA SAMI BADER Aim: The present study was conducted to evaluate the most common indications

More information

Prognosis of Very Large First-Trimester Hematomas

Prognosis of Very Large First-Trimester Hematomas Case Series Prognosis of Very Large First-Trimester Hematomas Juliana Leite, MD, Pamela Ross, RDMS, RDCS, A. Cristina Rossi, MD, Philippe Jeanty, MD, PhD Objective. The aim of this study was to evaluate

More information

Estimation of Fetal Weight: Mean Value from Multiple Formulas

Estimation of Fetal Weight: Mean Value from Multiple Formulas Estimation of Fetal Weight: Mean Value from Multiple Formulas Michael G. Pinette, MD, Yuqun Pan, MD, Sheila G. Pinette, RPA-C, Jacquelyn Blackstone, DO, John Garrett, Angelina Cartin Mean fetal weight

More information

Information for women after ultrasound detection of fetal renal pelvic dilatation (RPD)

Information for women after ultrasound detection of fetal renal pelvic dilatation (RPD) Information for women after ultrasound detection of fetal renal pelvic dilatation (RPD) The aim of this leaflet is to help explain what renal pelvis dilatation (RPD) means and to answer some of the questions

More information

Clinical Significance of First Trimester Umbilical Cord Cysts

Clinical Significance of First Trimester Umbilical Cord Cysts Clinical Significance of First Trimester Umbilical Cord Cysts Waldo Sepulveda, MD, Sergio Leible, MD, Angel Ulloa, MD, Milenko Ivankovic, MD, Carlos Schnapp, MD A cystic mass of the umbilical cord was

More information

Charts of fetal size: limb bones

Charts of fetal size: limb bones BJOG: an International Journal of Obstetrics and Gynaecology August 2002, Vol. 109, pp. 919 929 Charts of fetal size: limb bones Lyn S. Chitty a, *, Douglas G. Altman b Objective To construct new size

More information

Patient information on soft markers

Patient information on soft markers Patient information on soft markers Before you read this section remember the following important points. The vast majority of babies with soft markers are normal. Soft markers are frequently seen in healthy

More information

Long-Term Prognosis of Pregnancies Complicated by Slow Embryonic Heart Rates in the Early First Trimester

Long-Term Prognosis of Pregnancies Complicated by Slow Embryonic Heart Rates in the Early First Trimester Long-Term Prognosis of Pregnancies Complicated by Slow Embryonic Heart Rates in the Early First Trimester Peter M. Doubilet, MD, PhD, Carol B. Benson, MD, Jeanne S. Chow, MD Slow embryonic heart rates

More information

Sonographic Accuracy of Estimated Fetal Weight in Twins

Sonographic Accuracy of Estimated Fetal Weight in Twins ORIGINAL RESEARCH Sonographic Accuracy of Estimated Fetal Weight in Twins Lorie M. Harper, MD, MSCI, Kimberly A. Roehl, MPH, Methodius G. Tuuli, MD, MPH, Anthony O. Odibo, MD, MSCE, Alison G. Cahill, MD,

More information

Fetal Lateral Ventricular Width: What Should Be Its Upper Limit?

Fetal Lateral Ventricular Width: What Should Be Its Upper Limit? Article Fetal Lateral Ventricular Width: What Should Be Its Upper Limit? A Prospective Cohort Study and Reanalysis of the Current and Previous Data Benny Almog, MD, Ronni Gamzu, MD, PhD, Reuven Achiron,

More information

Ultrasonography of the Fetal Thyroid

Ultrasonography of the Fetal Thyroid Article Ultrasonography of the Fetal Thyroid Nomograms Based on Biparietal Diameter and Gestational Age Angela C. Ranzini, MD, Cande V. Ananth, PhD, MPH, John C. Smulian, MD, MPH, Michelle Kung, Anita

More information

Improving access and reducing costs of care for overactive bladder through a multidisciplinary delivery model

Improving access and reducing costs of care for overactive bladder through a multidisciplinary delivery model Improving access and reducing costs of care for overactive bladder through a multidisciplinary delivery model Trafford Crump, Ph.D. Department of Surgery, University of Calgary Presentation to: Canadian

More information

Assessment of Fetal Growth

Assessment of Fetal Growth Assessment of Fetal Growth Unit / Trust: 1. INTRODUCTION The aim of this guideline template is to outline the methods used to assess fetal growth and the referral pathways utilising customised antenatal

More information

Effect of Increased Body Mass Index on the Accuracy of Estimated Fetal Weight by Sonography in Twins

Effect of Increased Body Mass Index on the Accuracy of Estimated Fetal Weight by Sonography in Twins Article Effect of Increased Body Mass Index on the Accuracy of Estimated Fetal Weight by Sonography in Twins Manisha Gandhi, MD, Lauren Ferrara, MD, Victoria Belogolovkin, MD, Erin Moshier, MS, Andrei

More information

Data validation and Data sources

Data validation and Data sources British Isles Network of Congenital Anomaly Registers BINOCAR Standard Operating Procedure for Data validation and Data sources Instructions for the Registration and Surveillance of Congenital Anomalies

More information

SWISS SOCIETY OF NEONATOLOGY. Umbilical cord complications in two subsequent pregnancies

SWISS SOCIETY OF NEONATOLOGY. Umbilical cord complications in two subsequent pregnancies SWISS SOCIETY OF NEONATOLOGY Umbilical cord complications in two subsequent pregnancies June 2006 2 Hetzel PG, Godi E, Bührer C, Department of Neonatology (HPG, BC), University Children s Hospital, Basel,

More information

A. Evidence for an individually adjustable standard to assess birth weight:

A. Evidence for an individually adjustable standard to assess birth weight: Customised antenatal growth charts are designed to facilitate better supervision of fetal growth. The chart is printed out in early pregnancy, after confirmation of pregnancy dates, and allows serial plotting

More information

DETECTION AND NONOPERATIVE MANAGEMENT OF PEDIATRIC DEVELOPMENTAL DYSPLASIA OF THE HIP IN INFANTS UP TO SIX MONTHS OF AGE SUMMARY

DETECTION AND NONOPERATIVE MANAGEMENT OF PEDIATRIC DEVELOPMENTAL DYSPLASIA OF THE HIP IN INFANTS UP TO SIX MONTHS OF AGE SUMMARY DETECTION AND NONOPERATIVE MANAGEMENT OF PEDIATRIC DEVELOPMENTAL DYSPLASIA OF THE HIP IN INFANTS UP TO SIX MONTHS OF AGE SUMMARY Disclaimer This Clinical Practice Guideline was developed by an AAOS clinician

More information

Neural tube defects: open spina bifida (also called spina bifida cystica)

Neural tube defects: open spina bifida (also called spina bifida cystica) Screening Programmes Fetal Anomaly Neural tube defects: open spina bifida (also called spina bifida cystica) Information for health professionals Publication date: April 2012 Review date: April 2013 Version

More information

Ultrasonographic Diagnosis of Trisomy 18: Is It Practical in the Early Second Trimester?

Ultrasonographic Diagnosis of Trisomy 18: Is It Practical in the Early Second Trimester? Ultrasonographic Diagnosis of Trisomy 18: Is It Practical in the Early Second Trimester? Laurence E. Shields, MD, Leslie A. Carpenter, MS, CGC, Karin M. Smith, RDMS, Hanh V. Nghiem, MD The objective of

More information

Sonographic screening for trisomy 13 at 11 to 13 D6 weeks of gestation

Sonographic screening for trisomy 13 at 11 to 13 D6 weeks of gestation American Journal of Obstetrics and Gynecology (2006) 194, 397 401 www.ajog.org Sonographic screening for trisomy 13 at 11 to 13 D6 weeks of gestation Aris T. Papageorghiou, MD, a Kyriaki Avgidou, MD, a

More information

Congenital Diaphragmatic Hernia. Manuel A. Molina, M.D. University Hospital at Brooklyn SUNY Downstate

Congenital Diaphragmatic Hernia. Manuel A. Molina, M.D. University Hospital at Brooklyn SUNY Downstate Congenital Diaphragmatic Hernia Manuel A. Molina, M.D. University Hospital at Brooklyn SUNY Downstate Congenital Diaphragmatic Hernias Incidence 1 in 2000 to 5000 live births. 80% in the left side, 20%

More information

A single center experience with 1000 consecutive cases of multifetal pregnancy reduction

A single center experience with 1000 consecutive cases of multifetal pregnancy reduction A single center experience with 1000 consecutive cases of multifetal pregnancy reduction Joanne Stone, MD, Keith Eddleman, MD, Lauren Lynch, MD, and Richard L. Berkowitz, MD New York, NY, and San Juan,

More information

Who Is Involved in Your Care?

Who Is Involved in Your Care? Patient Education Page 3 Pregnancy and Giving Birth Who Is Involved in Your Care? Our goal is to surround you and your family with a safe environment for the birth of your baby. We look forward to providing

More information

Open the Flood Gates Urinary Obstruction and Kidney Stones. Dr. Jeffrey Rosenberg Dr. Emilio Lastarria Dr. Richard Kasulke

Open the Flood Gates Urinary Obstruction and Kidney Stones. Dr. Jeffrey Rosenberg Dr. Emilio Lastarria Dr. Richard Kasulke Open the Flood Gates Urinary Obstruction and Kidney Stones Dr. Jeffrey Rosenberg Dr. Emilio Lastarria Dr. Richard Kasulke Nephrology vs. Urology Nephrologist a physician who has been trained in the diagnosis

More information

ULTRASONOGRAPHIC EVALUATION OF HIP DYSPLASIA: review. L. Breysem, MD DEPARTMENT OF RADIOLOGY

ULTRASONOGRAPHIC EVALUATION OF HIP DYSPLASIA: review. L. Breysem, MD DEPARTMENT OF RADIOLOGY ULTRASONOGRAPHIC EVALUATION OF HIP DYSPLASIA: review L. Breysem, MD DEPARTMENT OF RADIOLOGY INTRODUCTION Clinical hip examination is part of the first routine examination of every newborn. An abnormal

More information

Article. Anthony O. Odibo, MD, Christopher Riddick, Emmanuelle Pare, MD, David M. Stamilio, MD, MSCE, George A. Macones, MD, MSCE

Article. Anthony O. Odibo, MD, Christopher Riddick, Emmanuelle Pare, MD, David M. Stamilio, MD, MSCE, George A. Macones, MD, MSCE Article Cerebroplacental Doppler Ratio and Adverse Perinatal Outcomes in Intrauterine Growth Restriction Evaluating the Impact of Using Gestational Age Specific Reference Values Anthony O. Odibo, MD, Christopher

More information

School of Diagnostic Medical Sonography

School of Diagnostic Medical Sonography Semester 1 Orientation - 101 This class is an introduction to sonography which includes a basic anatomy review, introduction to sonographic scanning techniques and physical principles. This curriculum

More information

Universal Fetal Cardiac Ultrasound At the Heart of Newborn Well-being

Universal Fetal Cardiac Ultrasound At the Heart of Newborn Well-being Universal Fetal Cardiac Ultrasound At the Heart of Newborn Well-being Optimizes detection of congenital heart disease (chd) in the general low risk obstetrical population Daniel J. Cohen, M.D. danjcohen@optonline.net

More information

Eastern Mediterranean Health Journal, Vol. 10, No. 3, 2004 437

Eastern Mediterranean Health Journal, Vol. 10, No. 3, 2004 437 Eastern Mediterranean Health Journal, Vol. 10, No. 3, 2004 437 Report Normal uterine size in women of reproductive age in northern Islamic Republic of Iran S. Esmaelzadeh, 1 N. Rezaei 1 and M. HajiAhmadi

More information

New Congenital Heart Disease Review

New Congenital Heart Disease Review New Congenital Heart Disease Review Item 8 Recommendations to improve antenatal and neonatal detection of congenital heart disease (CHD) 1. Abstract... 2 2. Introduction... 2 3. Methodology... 3 4. Findings...

More information

Prenatal screening and diagnostic tests

Prenatal screening and diagnostic tests Prenatal screening and diagnostic tests Contents Introduction 3 First trimester routine tests in the mother 3 Testing for health conditions in the baby 4 Why would you have a prenatal test? 6 What are

More information

Ovarian Torsion: Sonographic Evaluation

Ovarian Torsion: Sonographic Evaluation J Clin Ultrasound 17:327-332, June 1989 Ovarian Torsion: Sonographic Evaluation Mark A. Helvie, MD,* and Terry M. Silver, MDI Abstract: The sonographic and clinical findings of 13 patients with surgically

More information

General and Objectives Clinical Skills for. Nursing Students in Maternity and Gynecology. Nursing Department

General and Objectives Clinical Skills for. Nursing Students in Maternity and Gynecology. Nursing Department General and Objectives Clinical Skills for Nursing Students in Maternity and Gynecology Nursing Department Objectives and clinical skills of Antenatal unit Provide antenatal care to woman during normal

More information

Birth defects. Report by the Secretariat

Birth defects. Report by the Secretariat EXECUTIVE BOARD EB126/10 126th Session 3 December 2009 Provisional agenda item 4.7 Birth defects Report by the Secretariat 1. In May 2009 the Executive Board at its 125th session considered an agenda item

More information

Bladder Injury during Cesarean Section: A Case Control Study for 10 Years

Bladder Injury during Cesarean Section: A Case Control Study for 10 Years Bahrain Medical Bulletin, Vol., No., September Bladder Injury during Cesarean Section: A Case Control Study for Years Mesfer Al-Shahrani, MD, FRCSC* Objective: To determine the incidence, risk factors

More information

fi АУ : fi apple Ав Ав АУ . apple, АУ fiав Ав. АК applefi АУ, АУАв Ав fi АУ apple fi Ав. А applefi АУ АУ АУ АсА» Ас Ам, длappleapple Ас...

fi АУ : fi apple Ав Ав АУ . apple, АУ fiав Ав. АК applefi АУ, АУАв Ав fi АУ apple fi Ав. А applefi АУ АУ АУ АсА» Ас Ам, длappleapple Ас... АВАВАКдлАмА дла длама АсАядлАмА АВА АсдлАя & MАядлдлАмАК TА. 4, T. 2, АВ. 113-118, 2005 fi АУ : Аяapplefi. fiapple АсА» Ас Ам, длappleapple Ас..., Ая: Аяapplefi. fiapple, АВАУ Ас, АсА» Ас Ам длappleapple

More information

Population prevalence rates of birth defects: a data management and epidemiological perspective

Population prevalence rates of birth defects: a data management and epidemiological perspective Population prevalence rates of birth defects: a data management and epidemiological perspective Merilyn Riley Abstract The Victorian Birth Defects Register (VBDR) is a population-based surveillance system

More information

Maternity Care Primary C-Section Rate Specifications 2014 (07/01/2013 to 06/30/2014 Dates of Service)

Maternity Care Primary C-Section Rate Specifications 2014 (07/01/2013 to 06/30/2014 Dates of Service) Summary of Changes Denominator Changes: Two additions were made to the denominator criteria. The denominator was changed to include patients who had: a vertex position delivery AND a term pregnancy of

More information

Module 10: The Roles of Families, Community and the Health Care System in Prevention and Care for Women with Obstetric Fistula

Module 10: The Roles of Families, Community and the Health Care System in Prevention and Care for Women with Obstetric Fistula Prevention and Recognition of Obstetric Fistula Training Package Module 10: The Roles of Families, Community and the Health Care System in Prevention and Care for Women with Obstetric Fistula The Obstetric

More information

Free Echogenic Pelvic Fluid: Correlation with Hemoperitoneum

Free Echogenic Pelvic Fluid: Correlation with Hemoperitoneum Free Echogenic Pelvic Fluid: Correlation with Hemoperitoneum G. Kimberly Sickler, MD, Phebe C. Chen, MD, Theodore J. Dubinsky, MD, Nabil Maklad, MD, PhD Echogenic fluid is an important extrauterine finding

More information

Effects of Pregnancy & Delivery on Pelvic Floor

Effects of Pregnancy & Delivery on Pelvic Floor Effects of Pregnancy & Delivery on Pelvic Floor 吳 銘 斌 M.D., Ph.D. 財 團 法 人 奇 美 醫 院 婦 產 部 婦 女 泌 尿 暨 骨 盆 醫 學 科 ; 台 北 醫 學 大 學 醫 學 院 婦 產 學 科 ; 古 都 府 城 台 南 Introduction Pelvic floor disorders (PFDs) include

More information

Differentiation between normal and abnormal fetal growth

Differentiation between normal and abnormal fetal growth Differentiation between normal and abnormal fetal growth JASON GARDOSI MD FRCSE FRCOG Director, West Midlands Perinatal Institute, St Chad s Court, 213 Hagley Road, Birmingham B16 9RG, U.K. Tel +44 (0)121

More information

Motor Vehicle Injuries

Motor Vehicle Injuries Motor Vehicle Injuries Prenatal Counseling about Seat Belt Use during Pregnancy and Injuries from Car Crashes during Pregnancy Background The CDC has identified prevention of motor vehicle injuries as

More information

Lyme Disease in Pregnancy. Dr Sarah Chissell Consultant Obstetrician William Harvey Hospital, Kent

Lyme Disease in Pregnancy. Dr Sarah Chissell Consultant Obstetrician William Harvey Hospital, Kent Lyme Disease in Pregnancy Dr Sarah Chissell Consultant Obstetrician William Harvey Hospital, Kent Conflict of interest My son has chronic Lyme disease Infections in pregnancy Transplacental infection Perinatal

More information

Sonographic Diagnosis of Ureteral Tumors

Sonographic Diagnosis of Ureteral Tumors Sonographic Diagnosis of Ureteral Tumors Irith Hadas-Halpern, MD, micur Farkas, MD, Michael Patlas, MD, Ibrahim Zaghal, MD, Shoshana Sabag-Gottschalk, MD, Drora Fisher, MD We present our experience with

More information

Careful collection, organization and review of medical information

Careful collection, organization and review of medical information Preparing Birth Injury Case Prior To Expert Review of Causation Careful collection, organization and review of medical information essential to documentation of injury By RICHARD A. SILVER When analyzing

More information

What is the diagnostic value of ultrasound for determining a viable intrauterine pregnancy?

What is the diagnostic value of ultrasound for determining a viable intrauterine pregnancy? What is the diagnostic value of ultrasound for determining a viable intrauterine pregnancy? Full citation Sample size Tests Methods Results Limitations Steinkampf,M.P., Guzick,D.S., Hammond,K.R., Blackwell,R.E.,

More information

Chapter 10. When Abortion Fails

Chapter 10. When Abortion Fails Chapter 10 When Abortion Fails Occasionally abortion fails, especially when it is drug induced. When this happens, either a second D&C or a more serious surgery may be attempted. The other alternative

More information

Sonographic Evaluation of the Lower Uterine Segment in Patients With Previous Cesarean Delivery

Sonographic Evaluation of the Lower Uterine Segment in Patients With Previous Cesarean Delivery Article Sonographic Evaluation of the Lower Uterine Segment in Patients With Previous Cesarean Delivery Vincent Y. T. Cheung, MBBS, FRCOG, FRCSC, RDMS, Oana C. Constantinescu, MD, RDMS, Birinder S. Ahluwalia,

More information

Clinical Studies Abstract Booklet

Clinical Studies Abstract Booklet Clinical Studies Abstract Booklet The Harmony Prenatal Test is a non-invasive prenatal test (NIPT) that assesses the risk of trisomies by analyzing cell-free DNA (cfdna) in maternal blood. Since January

More information

Provider Notification Obstetrical Billing

Provider Notification Obstetrical Billing Provider Notification Obstetrical Billing Date of Notification September 1, 20 Revision Date September 17, 2015 Plans Affected Mercy Care Plan and Mercy Care Long Term Care Plan Referrals As outlined in

More information

Rural Health Advisory Committee s Rural Obstetric Services Work Group

Rural Health Advisory Committee s Rural Obstetric Services Work Group Rural Health Advisory Committee s Rural Obstetric Services Work Group March 15 th webinar topic: Rural Obstetric Patient and Community Issues Audio: 888-742-5095, conference code 6054760826 Rural Obstetric

More information

Alana Obstetrics A familiar face to deliver your baby..

Alana Obstetrics A familiar face to deliver your baby.. Alana Obstetrics A familiar face to deliver your baby.. Congratulations on your pregnancy and welcome to Alana Obstetrics! Dr Burke, Dr Alejandra Izurieta and Dr Erin Nesbitt-Hawes are your team of Obstetricians

More information

NATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE CENTRE FOR CLINICAL PRACTICE QUALITY STANDARDS PROGRAMME

NATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE CENTRE FOR CLINICAL PRACTICE QUALITY STANDARDS PROGRAMME NATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE CENTRE FOR CLINICAL PRACTICE QUALITY STANDARDS PROGRAMME standard topic: Specialist neonatal care Output: standard advice to the Secretary of State

More information

Parvovirus B19 Infection in Pregnancy

Parvovirus B19 Infection in Pregnancy Parvovirus B19 Infection in Pregnancy Information Pack Parvovirus B19 Infection in Pregnancy Information Booklet CONTENTS: THE VIRUS page 3 CLINICAL MANIFESTATIONS page 6 DIAGNOSIS page 8 PATIENT MANAGEMENT

More information

Placental Surface Cysts Detected on Sonography

Placental Surface Cysts Detected on Sonography Article Placental Surface Cysts Detected on Sonography Histologic and Clinical Correlation Douglas L. Brown, MD, Donald N. DiSalvo, MD, Mary C. Frates, MD, Karen M. Davidson, MD, David R. Genest, MD Objective.

More information

Fetuses With Trisomy 21 Having Conflicting Findings on Antenatal Testing for Fetal Well-being

Fetuses With Trisomy 21 Having Conflicting Findings on Antenatal Testing for Fetal Well-being Case Series Fetuses With Trisomy 21 Having Conflicting Findings on Antenatal Testing for Fetal Well-being Geoffrey Wong, MD, Deborah Levine, MD Objective. This series reports 3 cases with conflicting antenatal

More information

A test your patients can trust.

A test your patients can trust. A test your patients can trust. A simple, safe, and accurate non-invasive prenatal test for early risk assessment of Down syndrome and other conditions. informaseq Prenatal Test Simple, safe, and accurate

More information

Society of Nuclear Medicine Procedure Guideline for Diuretic Renography in Children

Society of Nuclear Medicine Procedure Guideline for Diuretic Renography in Children Society of Nuclear Medicine Procedure Guideline for Diuretic Renography in Children version 2.0, approved February 7, 1999 Authors: Gerald A. Mandell, MD (DuPont Hospital for Children, Wilmington, DE);

More information

CODE AUDITING RULES. SAMPLE Medical Policy Rationale

CODE AUDITING RULES. SAMPLE Medical Policy Rationale CODE AUDITING RULES As part of Coventry Health Care of Missouri, Inc s commitment to improve business processes, we are implemented a new payment policy program that applies to claims processed on August

More information

Management and Treatment Guidelines for Cornelia de Lange Syndrome

Management and Treatment Guidelines for Cornelia de Lange Syndrome Management and Treatment Guidelines for Cornelia de Lange Syndrome These cards highlight routine care for people with CdLS needed by specific age groups, including infancy, early and late childhood, adolescence

More information

FETAL RENAL ANOMALIES: diagnosis, management and outcome.

FETAL RENAL ANOMALIES: diagnosis, management and outcome. FETAL RENAL ANOMALIES: diagnosis, management and outcome. cover: Albert Damen sr. print Budde-Elinkwijk, Nieuwegein FETAL RENAL ANOMALIES: diagnosis, management and outcome Afwijkingen aan nieren en urinewegen

More information

Down s Syndrome: Ultrasound Screening

Down s Syndrome: Ultrasound Screening October 2001 Down s Syndrome: Ultrasound Screening Hilary Hochberg Advanced Radiology Clerkship Dr. Gillian Lieberman Patient M.C. 32 year old female presents at 16 weeks gestational age with abnormal

More information

Maternity billing codes

Maternity billing codes Maternity Billing The Maternity Period - For billing purposes, the obstetrical period begins on the date of the initial visit in which pregnancy was confirmed and extends through the end of the postpartum

More information

Regions Hospital Delineation of Privileges Nurse Practitioner

Regions Hospital Delineation of Privileges Nurse Practitioner Regions Hospital Delineation of Privileges Nurse Practitioner Applicant s Last First M. Instructions: Place a check-mark where indicated for each core group you are requesting. Review education and basic

More information

Prediction of Pregnancy Outcome Using HCG, CA125 and Progesterone in Cases of Habitual Abortions

Prediction of Pregnancy Outcome Using HCG, CA125 and Progesterone in Cases of Habitual Abortions Prediction of Pregnancy Outcome Using HCG, CA125 and Progesterone in * (MBChB, FICMS, CABOG) **Sawsan Talib Salman (MBChB, FICMS, CABOG) ***Huda Khaleel Ibrahim (MBChB) Abstract Background: - Although

More information

Ultrasonographic Estimation of Fetal Weight

Ultrasonographic Estimation of Fetal Weight Article Ultrasonographic Estimation of Fetal Weight Acquiring Accuracy in Residency Mladen Predanic, MD, MSc, Angel Cho, MD, Flores Ingrid, MD, John Pellettieri, MD Objective. Ultrasonographic imaging

More information

Prevention and Recognition of Obstetric Fistula Training Package. Module 8: Pre-repair Care and Referral for Women with Obstetric Fistula

Prevention and Recognition of Obstetric Fistula Training Package. Module 8: Pre-repair Care and Referral for Women with Obstetric Fistula Prevention and Recognition of Obstetric Fistula Training Package Module 8: Pre-repair Care and Referral for Women with Obstetric Fistula Early detection and treatment If a woman has recently survived a

More information

CONFIDENT CODING FOR OB/GYN CONFIDENT CODING FOR OB/GYN

CONFIDENT CODING FOR OB/GYN CONFIDENT CODING FOR OB/GYN Arlene J. Smith, CPC AAPC National Advisory Board 2007-2009 1 So when exactly does the global period start? Unraveling the confusion in antepartum care coding Correct coding for multiple gestations! Vaginal

More information

Sonographic Features Related to Volvulus in Neonatal Intestinal Malrotation

Sonographic Features Related to Volvulus in Neonatal Intestinal Malrotation Sonographic Features Related to Volvulus in Neonatal Intestinal Malrotation Hsun-Chin Chao, MD, Man-Shan Kong, MD, Ju-Yi Chen, MD, Syh-Jae Lin, MD, Jer-Nan Lin, MD This 3 year prospective study evaluated

More information

The National Down Syndrome Cytogenetic Register for England and Wales: 2008/9 Annual Report

The National Down Syndrome Cytogenetic Register for England and Wales: 2008/9 Annual Report 0 The National Down Syndrome Cytogenetic Register for England and Wales: 2008/9 Annual Report Joan K Morris, Elizabeth De Souza December 2009 National Down Syndrome Cytogenetic Register Queen Mary University

More information

School of Diagnostic Medical Sonography Course Catalog

School of Diagnostic Medical Sonography Course Catalog School of Diagnostic Medical Sonography Course Catalog 2 School of Diagnostic Medical Sonography Course Schedule Our program provides a broad base of education and performance- based clinical experience

More information

School of Diagnostic Medical Sonography Course Catalog

School of Diagnostic Medical Sonography Course Catalog School of Diagnostic Medical Sonography Course Catalog 2 School of Diagnostic Medical Sonography Course Schedule Our program provides a broad base of education and performance- based clinical experience

More information

a guide to understanding pierre robin sequence

a guide to understanding pierre robin sequence a guide to understanding pierre robin sequence a publication of children s craniofacial association a guide to understanding pierre robin sequence this parent s guide to Pierre Robin Sequence is designed

More information

OBSTETRICAL POLICY. Page

OBSTETRICAL POLICY. Page OBSTETRICAL POLICY REIMBURSEMENT POLICY Policy Number: ADMINISTRATIVE 200.14 T0 Effective Date: April 1, 2016 Table of Contents APPLICABLE LINES OF BUSINESS/PRODUCTS... APPLICATION... OVERVIEW... REIMBURSEMENT

More information

ROUTINE HEART EXAM AND

ROUTINE HEART EXAM AND INFORMATION FOR PARENTS ROUTINE HEART EXAM AND BIOBANK IN ALL NEWBORNS In the Copenhagen area 2016-2018 You have the option to let your child join a research study conducted by doctors with expertise in

More information

The sensitive marker for glomerular filtration rate (GFR) Estimation of GFR from Serum Cystatin C:

The sensitive marker for glomerular filtration rate (GFR) Estimation of GFR from Serum Cystatin C: The sensitive marker for glomerular filtration rate (GFR) Estimation of GFR from Serum Cystatin C: The good correlation allows close estimation of GFR Cystatin C GFR GFR in serum estimated* measured* n

More information

Telehealth for High-risk Pregnancy

Telehealth for High-risk Pregnancy Thi sdocumentwasmadepos s i bl ebygr ant#g22rh251 6701 01f r om t heof ficef ort headvancementoft el eheal t h,heal t hres our cesandser vi cesadmi ni s t r at i on,dhhs. State Medicaid Best Practice Telehealth

More information

REPRODUCTIVE ENDOCRINOLOGY

REPRODUCTIVE ENDOCRINOLOGY FERTILITY AND STERILITY VOL. 82, NO. 5, NOVEMBER 2004 Copyright 2004 American Society for Reproductive Medicine Published by Elsevier Inc. Printed on acid-free paper in U.S.A. REPRODUCTIVE ENDOCRINOLOGY

More information

CHLAMYDIA SCREENING IN WOMEN

CHLAMYDIA SCREENING IN WOMEN CHLAMYDIA SCREENING IN WOMEN APPLICATIONS OBJECTIVE Purpose of Measure: ELIGIBLE POPULATION Which members are included? STANDARD OF CARE What screening should be done? NCQA ACCEPTED CODES DOCUMENTATION

More information

PJPC Meeting Minutes Monday, September 25 th, 2006

PJPC Meeting Minutes Monday, September 25 th, 2006 Cosmas J. M. van de Ven, MD Director, Maternal-Fetal Medicine Phone: (734) 936-7573 Fax: (734) 647-1006 E-mail: cosmas@umich.edu F 4835 Mott Hospital 1500 E. Medical Center Drive Ann Arbor, MI 48109-0264

More information

Safe and Effective Surgery for Endometriosis Including Detection and Intervention for Ovarian Cancer

Safe and Effective Surgery for Endometriosis Including Detection and Intervention for Ovarian Cancer Safe and Effective Surgery for Endometriosis Including Detection and Intervention for Ovarian Cancer Camran Nezhat,, MD, FACOG, FACS Stanford University Medical Center Center for Special Minimally Invasive

More information

CONGENITAL HEART DISEASE

CONGENITAL HEART DISEASE CONGENITAL HEART DISEASE Introduction Congenital heart disease (CHD) is the most common congenital disorder in newborns [1]. Due to definitional issues, there are large variations in prevalence estimates.

More information

Clinical Policy Title: Home uterine activity monitoring

Clinical Policy Title: Home uterine activity monitoring Clinical Policy Title: Home uterine activity monitoring Clinical Policy Number: 12.01.01 Effective Date: August 19, 2015 Initial Review Date: July 17, 2013 Most Recent Review Date: July 15, 2015 Next Review

More information

ESPR-Meeting, Barcelona/Spain, June 2007

ESPR-Meeting, Barcelona/Spain, June 2007 Imaging recommendations in paediatric uroradiology: Minutes of the ESPR workgroup session on urinary tract infection, fetal hydronephrosis, urinary tract ultrasonography and voiding cystourethrography

More information

Doppler Ultrasound in the Management of Fetal Growth Restriction Chukwuma I. Onyeije, M.D. Atlanta Perinatal Associates

Doppler Ultrasound in the Management of Fetal Growth Restriction Chukwuma I. Onyeije, M.D. Atlanta Perinatal Associates Doppler Ultrasound in the Management of Fetal Growth Restriction Chukwuma I. Onyeije, M.D. Atlanta Perinatal Associates 1 For your convenience a copy of this lecture is available for review and download

More information

Non-Invasive Prenatal Testing (NIPT) Factsheet

Non-Invasive Prenatal Testing (NIPT) Factsheet Introduction NIPT, which analyzes cell-free fetal DNA circulating in maternal blood, is a new option in the prenatal screening and testing paradigm for trisomy 21 and a few other fetal chromosomal aneuploidies.

More information

CROSS HEALTH CARE BOUNDARIES MATERNITY CLINICAL GUIDELINE

CROSS HEALTH CARE BOUNDARIES MATERNITY CLINICAL GUIDELINE CROSS HEALTH CARE BOUNDARIES MATERNITY CLINICAL GUIDELINE Title of Guideline (must include the word Guideline (not protocol, policy, procedure etc) Obstetric Early Warning Score Guideline Implementation

More information

Percutaneous drainage as the treatment of choice for neonatal ovarian cysts

Percutaneous drainage as the treatment of choice for neonatal ovarian cysts Pediatr Radiol DOI 10.1007/s00247-006-0240-0 ORIGINAL ARTICLE Ada Kessler. Hagith Nagar. Moshe Graif. Liat Ben-Sira. Elka Miller. Drora Fisher. Irith Hadas-Halperin Percutaneous drainage as the treatment

More information

Harlem Hospital Center Integrated Radiology Residency Program Mammography Educational goals and objectives

Harlem Hospital Center Integrated Radiology Residency Program Mammography Educational goals and objectives Harlem Hospital Center Integrated Radiology Residency Program Mammography Educational goals and objectives Rotation 1 (Radiology year 1/2) Knowledge Based Objectives: At the end of the rotation, the resident

More information

Learning Resource Guide. Understanding Incontinence. 2000 Prism Innovations, Inc. All Rights Reserved

Learning Resource Guide. Understanding Incontinence. 2000 Prism Innovations, Inc. All Rights Reserved Learning Resource Guide Understanding Incontinence 2000 Prism Innovations, Inc. All Rights Reserved ElderCare Online s Learning Resource Guide Understanding Incontinence Table of Contents Introduction

More information

Cerebral palsy, neonatal death and stillbirth rates Victoria, 1973-1999

Cerebral palsy, neonatal death and stillbirth rates Victoria, 1973-1999 Cerebral Palsy: Aetiology, Associated Problems and Management Lecture for FRACP candidates July 2010 Definitions and prevalence Risk factors and aetiology Associated problems Management options Cerebral

More information

Accuracy of Ultrasound Estimation of Fetal Weight by Obstetrics and Gynaecology Residents and Maternal-fetal Medicine Subspecialists

Accuracy of Ultrasound Estimation of Fetal Weight by Obstetrics and Gynaecology Residents and Maternal-fetal Medicine Subspecialists Ultrasound Estimation of Fetal Weight Accuracy of Ultrasound Estimation of Fetal Weight by Obstetrics and Gynaecology Residents and Maternal-fetal Medicine Subspecialists PKS YAU MBChB, MRCOG (UK) WK SIN

More information

Department of Veterans Affairs VHA HANDBOOK 1330.03. Washington, DC 20420 October 5, 2012 MATERNITY HEALTH CARE AND COORDINATION

Department of Veterans Affairs VHA HANDBOOK 1330.03. Washington, DC 20420 October 5, 2012 MATERNITY HEALTH CARE AND COORDINATION Department of Veterans Affairs VHA HANDBOOK 1330.03 Veterans Health Administration Transmittal Sheet Washington, DC 20420 October 5, 2012 MATERNITY HEALTH CARE AND COORDINATION 1. REASON FOR ISSUE. This

More information

OBGYN Orientation & Billing Guide 9/22/2014

OBGYN Orientation & Billing Guide 9/22/2014 OBGYN Orientation & Billing Guide 2014 Welcome to Magnolia Health! We thank you for being part of or considering Magnolia s network of participating providers, hospitals, and other healthcare professionals.

More information