Pregnancy and Birth

This image presents a hysteroscopic view of normal tubal ostium.

Fibroids and Hysterectomies used to go together like Rogers and Hammerstein. Not anymore. If your physician recommends removing your uterus as the most effective treatment for severe fibroids without first considering less invasive therapies, start singing another tune and get a second opinion!

Have you ever noticed how easily misinformation develops and how eagerly it is spread by the ill informed? Of late I have heard and read all manner of seemingly authoritative pronouncements on uterine artery embolization (UAE) for the management of uterine myomas. I even saw an "authority" recently on OPRAH stating that UAE was experimental and not useful for tumors larger 4 cms.

48 year old woman, a tumor in abdomen was discovered. No complaints now except anemia (Hb 4,4 mmol/l). After second delivery (17 years ago) period of abdominal pains. The cystic mass is WITHIN the fundal myometrium.

One hundred and six pregnant women diagnosed with Leiomyoma during pregnancy were evaluated clinically and by ultrasound. Leiomyoma size changes were analyzed on the basis of trimesters. The common echotexture pattern and the different echotextures as well as any changes in the echogenicity were noticed during the follow up. The number and location of the myomata were observed with their impact on pregnancy outcome.

This is the 30 year old wife of a colleague, G2 P1, 19 weeks pregnant. This is a known myoma, posterior and left. Part of the placenta is implanted over this myoma.

K.C., a 44 year-old woman, called me from upstate New York. Over the past 15 years her uterus has gradually enlarged to the size of a seven month pregnancy due to the presence of multiple fibroids. She also suffered from asthma and her markedly enlarged uterus was contributing to her breathing difficulties. Her periods had become progressively heavier, leading to anemia.

Mrs. Blumenthal*, a 40-year-old G1P1, had young twins at home and was also a full-time student. She delivered her twins in 1992 by C-section after conceiving through IVF. The patient had long-standing endometriosis, treated previously by three abdominal procedures (one laparotomy and two laparoscopies).

In late 1996 Mrs. Martin contacted our office and reported concern over the fact that her periods were occurring every 2 weeks. During the office visit, she stated that she was experiencing heavy bleeding with the passage of clots that lasted approximately 7 days, requiring the use of 10 or more pads per day. The problem was very upsetting to her and was interfering with daily life at home and at work.

Laparoscopy is one of the most common surgical procedures performed in the United States today. It is the modality of choice for many physicians for removal of ectopic pregnancy, bilateral tubal sterilization, treatment of endometriosis, lysis of adhesions, cholecystectomy, appendectomy, splenectomy, prostatectomy, etc. It is becoming increasingly popular for more complex procedures, including laparoscopic hysterectomy and myomectomy.

Transvaginal Ultrasonography, Sonohysterography, Hysterosalpingography And Operative Hysteroscopy In Predicting Endometrial Hyperplasia

Reproductive endocrinology, a relatively new subspecialty of obstetrics and Gynecology, came of age during the 1980s. The discipline has benefited greatly from substantial recent advances in reproductive biology and allied fields and technologic improvements in computers, ultrasonography, and surgical instrumentation. All of these developments have been applied to clinical practice at an unprecedented rate.

Many clinicians and perhaps some statisticians are at odds regarding the correct application of Bayes theorem in integrated risk assessments of screening programs for Down syndrome1. Most standard textbooks show that the posterior odds = prior odds X likelihood ratio but some publications show the use of prior risk X likelihood ratio to calculate the posterior risk. Bayes theorem does refer to probabilities, which is equivalent to the word "risk"

Since the first report of Doppler ultrasound evaluating high-risk pregnancies in 1983, the fetal arterial system has been extensively studied to determine if abnormal waveforms identify fetuses at increased risk for perinatal mortality.

The Prenatal Ultrasonographic Detection of Myelomeningocele in Patients Referred to Children's Hospital Medical Center

Uterine myomas irrespective of whether they are small and asymptomatic (as in the postmenopausal women) or large and symptomatic (as in premenopausal women) considerably affect uterine artery blood flow velocity. Benign uterine leiomyomas are usually easily recognized with gray-scale ultrasonography, but may sometimes be difficult to differentiate from solid ovarian tumours.

Differential Diagnosis of the Placental Adhesive Disorders by Contrasted Nuclear Magnetic Resonance & Ultrasound - Placenta Accreta and Percreta

Some of you know that I have long been an advocate of miniaturization in Sonography, and predicted that we will all be Cyborgs within 5 years. Well, one of our own, Master Sgt. Cheryl Vance, a diagnostic sonography instructor assigned to the 382nd Training Squadron at Sheppard Air Force Base, Texas (yes, SDMS Region 3 rules the future!) may well be the first Sonographic Cyborg on Earth! Or would that be a "SonoBorg"?

Portable Ultrasound - An Interview with Cheryl Vance Terry J. DuBose, M.S., RDMS, OBGYN.net Editorial Advisor interviews Cheryl Vance, MA, RDMS, RVT, OBGYN.net Editorial Advisor, 382nd Training Squadron at Sheppard Air Force Base, Texas  

The Air Force has a program, the Education and Training Technology Application Program (ETTAP), specifically geared to introduce new technology into the training environment. This program funds initiatives to incorporate the latest advances in technology into the training setting.

OST's ultrasound laboratory is developing the test methods manufacturers need to assure the safety of their diagnostic equipment. This was accomplished in two related studies concerning hydrophones.

The offering of amniocentesis or chorionic villus sampling (CVS) for chromosome studies is recommended for pregnant women at high risk for Down syndrome. The offering of screening for Down syndrome by serum multiple-marker testing is recommended for all low-risk pregnant women, and as an alternative to amniocentesis and CVS for high-risk women.

A study unveiled today at the 24th annual Society for Maternal-Fetal Medicine (SMFM) meeting brings hope to all pregnant women looking for an early, non-invasive way to assess their risk of delivering a baby with Down Syndrome. The trial reveals that measuring fetal neck fold thickness (nuchal translucency) by ultrasound, combined with a measurement of biochemical markers, is effective in the first trimester.

Pre eclampsia, sometimes called toxemia, is a unique and often dangerous condition that only occurs during pregnancy. Most experts define PRE ECLAMPSIA as an elevation in blood pressure in a pregnant woman of 140/90, with protein in the urine, or swelling (edema) of the feet, hands, and/or face. The condition occurs more commonly during first pregnancies, with twins or triplets, in very young or older women, and when a woman has had pre eclampsia with previous pregnancies.

This series describe an innovative approach for anterior placenta percreta surgery. The procedure has been developed in Argentina and is intended to limit obstetric bleeding and hysterectomy incidence. Though definite results will be reported later, a uterine preservation rate of about 90% with a mean transfusion need of 1000 ml has been achieved.