By Robert V. Giglia R.T., R.D.M.S., Kara L. Mayden R. T., R.D.M.S., Norbert Gleicher M. D. (auth.)
Real-time ultrasonography has entered workplace perform in obstetrics and gynecology. With expanding numbers of sonography platforms coming into the ambulatory workplace environment, obstetric sonography at a regimen point (level I) has principally been the particular zone. contemporary advancements in gynecologic real-time sonography have, even though, considerably enlarged the sector of applicability of sonographic gear in an place of work atmosphere. The very speedy development of follicular sonography in infertility review and administration has made real-time sonography of accelerating value to the gynecologic practitioner. In workplace settings just like the authors', gynecologic workplace sonography represents just about 50% of all ordered sonography. This instruction manual of place of work sonography in obstetrics and gynecology was once conceived to mirror those adjustments in perform styles. This quantity isn't intended to interchange typical sonography texts for the full-time sonographer yet is as a substitute directed towards the working towards obstetrician/gynecologist who makes use of real-time sonography within the place of work environment in the framework of day-by-day perform. Technical reviews have been as a result constrained to a minimal, with useful recommendation and photographic examples taking their position. lots of the sonographic real-time photos have been retrieved from the authors' personal records. even though, a few have been received in the course of the generosity of associates and associates, for which we wish to increase acknowledgment and appreciation. related appreciation is prolonged to Dr. Haim Elrad and Dr. Jari Friberg, who additionally participated within the editorial method; to Sheila Martin, who played beautifully as our editorial assistant, a such a lot tricky accountability; and to Hilary Evans, our editor at Plenum Publishing Corporation.
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Additional info for A Practical Guide to Real-Time Office Sonography in Obstetrics and Gynecology
B) Transverse scan demonstrating the umbilical cord (arrows) visualizing two arteries (A) and the umbilical vein (V) . Placenta (P) . FIG. 2. PLACENTAL INSERTION OF THE FETAL CORD Placenta (P) , insertion point (arrow) . 2. 1. General Aspects • Unless the situation of a threatened abortion exists, first trimester sonography of the placenta has no specific clinically defined value. Sonographic evaluation of first trimester bleeding is discussed in Chapter 13. • Placental sonography during the second trimester is primarily important for placental localization (see Fig.
Normal fetal ureters are difficult to define sonographically. Clear visualization of a fetal ureter may be indicative of hydroureter and requires further evaluation. ) • The fetal adrenals can usually be identified superior to the kidneys. Note that hypertrophy of the adrenals, particularly in conjunction with renal agenesis, can result in the false identification of adrenals for kidneys. PART I • REAL-TIME SONOGRAPHV IN OBSTETRICS FIG. 1. LOCATION OF THE FETAL KIDNEYS Transverse scan with the fetus in the spine-up position demonstrating the normal fetal kidneys (k) adjacent to the spine (s).
The basal plate of the placenta should also run as an uninterrupted echogenic line. An interrupted echogenic line may be indicative of uterine activity, underlying intrauterine fibroid tumors, or placental aging. ) • The observation of cystic clear spaces within the placenta does not always represent pathologic findings. Such areas are frequently seen at the lateral margins of the placenta and immediately beneath the chorionic plate, particularly adjacent to the cord insertion. They need to be differentiated from placental hematomas, which may occur in conjunction with placental abruption.