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What Does My Lab Test Report Indicate?

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Posted on Mon, 3 Oct 2016
Question: Please explain the report...

Diamniotic twins

Twin a
Bpd 8.2cms 33weeks
Hc 29.3cms 32 weeks
Ac 24.6cms 29 weeks
Fl 6.5 cm's 33 weeks
Hc/ac 1.19
Fl/ac 26%
Fl/bpd 79%

TWIN B

Bpd 8..0CMS 32 WEEKS
Hc 28..8CMS 32 weeks
Ac 28.6cms 32 weeks
Fl 6.3 cm's 32 weeks
Hc/ac 1.03
Fl/ac 22%
Fl/bpd 78%

Weight estimate
Twin a 1709 gms +|- 250 gms
Twin b 1925 gms +|- 281 gms

S/d ratio
Twin a 3.4
Twin b 2.3

Impression

AC parameters lesser in twin a[ mild asymmetric IUGR]

Breech presentation---- twin a

Elevated S/D ratio in --) twin a

Fetel right renal pelvis prominence in Twin B


Please explain... My doctor said its not big problem as delivery date is 4weeks exists...
doctor
Answered by Dr. Sameer Kumar (1 hour later)
Brief Answer:
twin a is smaller than twin B ....explained.

Detailed Answer:
Hello,
Thanks for the query to HCM,
The report clearly indicates that the TWIN A is smaller than TWIN B with Intra uterine growth retardation in twin A as evidenced by raised FL/AC ratio and also the S/D ratio. So as the presenting twin A is breech, and concerning the period of gestation being 32 weeks approx, the further monitoring should be done with weekly doppler and NST studies hence to check for any reversal of umbilical artery flow or absent blood flow in twin A.
The delivery should be elective c-section at 36-37 weeks if all reports are normal.
Regards
Above answer was peer-reviewed by : Dr. Priyanka G Raj
doctor
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Follow up: Dr. Sameer Kumar (5 hours later)
What kind of diet and precautions to be taken for safe and healthy babies delivery at this point of time..???
doctor
Answered by Dr. Sameer Kumar (21 minutes later)
Brief Answer:
answered

Detailed Answer:
DIET per se will not be helpful. As it is twins, one is likely to be of low weight as most often see. All can be done is monitoring of umbilical artery doppler and NST weekly to check for increase in circulatory insult to twin A, to decide time for delivery. Arginine satchets may be taken daily but they are of restrictive use at already 33 weeks.
Regards
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
Answered by
Dr.
Dr. Sameer Kumar

OB and GYN Specialist

Practicing since :2002

Answered : 1782 Questions

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What Does My Lab Test Report Indicate?

Brief Answer: twin a is smaller than twin B ....explained. Detailed Answer: Hello, Thanks for the query to HCM, The report clearly indicates that the TWIN A is smaller than TWIN B with Intra uterine growth retardation in twin A as evidenced by raised FL/AC ratio and also the S/D ratio. So as the presenting twin A is breech, and concerning the period of gestation being 32 weeks approx, the further monitoring should be done with weekly doppler and NST studies hence to check for any reversal of umbilical artery flow or absent blood flow in twin A. The delivery should be elective c-section at 36-37 weeks if all reports are normal. Regards