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4 results

  • Chapter 25 - Ultrasonography and hydrosalpinges in IVF

  • from Section 3: - Ultrasonography in assisted reproduction
  • Edited by Botros R. M. B. Rizk, University of South Alabama
  • Book:
    Ultrasonography in Reproductive Medicine and Infertility
    Published online:
    07 September 2011
    Print publication:
    25 March 2010, pp 202-212

  • Summary

    Hysterosalpingography (HSG) is the first diagnostic test used for patients with suspected mllerian anomalies. HSG can detect a two-chambered uterus and allow assessment of the size and extent of a septum. Two-dimensional (2D) ultrasonography was previously done by the transabdominal route, but transvaginal ultrasonography (TVS) is superior to the transabdominal route and is now the standard imaging technique for the uterus. The main advantage of three-dimensional (3D) ultrasonography over 2D is the ability to image the three orthogonal planes of the uterus, of which the coronal view is the most important. Sonohysterography is an ultrasound-aided technique that entails injection of normal saline into the uterine cavity. Many magnetic resonance imaging (MRI) studies have shown a very high sensitivity of 100%, and more recently values of 95% have been reported in cases of mllerian anomalies. Uterine mllerian anomalies have a high frequency of adverse obstetric implications.

  • 16 - Non-tubal ectopic pregnancies

  • Edited by Davor Jurkovic, Lil Valentin, Sanjay Vyas
  • Book:
    Gynaecological Ultrasound in Clinical Practice
    Published online:
    05 February 2014
    Print publication:
    01 June 2009, pp 193-210

  • Summary

    This chapter provides a summary of each type of non-tubal ectopic pregnancy, with particular emphasis on the ultrasound diagnosis and management options. Interstitial pregnancy is characterised by the implantation of the conceptus in the interstitial portion of the fallopian tube, which is surrounded by the muscular wall of the uterus. The advances in high-resolution transvaginal ultrasonography and the establishment of early pregnancy units have facilitated the early non-invasive diagnosis of interstitial pregnancy before complications occur. This has opened the door for more conservative management options such as medical treatment with methotrexate. The management of interstitial pregnancy was surgical, in the form of cornual resection or hysterectomy. The reason for this was the late detection of this condition, which used to be diagnosed at laparotomy following tubal rupture. Medical management using methotrexate, a folate antagonist, has been increasingly used in the treatment of women identified as having an unruptured interstitial pregnancy.

  • Yolk Sacs in Twin Pregnancy

  • W. Malinowski
  • Journal:
    Acta geneticae medicae et gemellologiae: twin research / Volume 47 / Issue 3-4 / October 1998
    Published online by Cambridge University Press:
    01 August 2014, pp. 177-181
    Print publication:
    October 1998
    • Article
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  • OBJECTIVE. The purpose of this study was to evaluate the relationship between the yolk sacs separated or not separated by septum and chorionicity twin pregnancies scanned early in the first trimester, and the relation between size and morphologic features of the yolk sac and the outcome of twin pregnancies.

    RESULTS. In all 38 sets of twins two yolk sacs were identified. During the first trimester of a dichorionic twin pregnancy, the yolk sacs were always separated by a septum and not separated (“Eight” sign) in monochorionic twin pregnancy. In five cases, one of yolk sac was abnormally large (> 8mm) and had thin wall. Four of the five mothers spontaneously aborted during the next 2-3 weeks. In one case of monochorionic twin ectopic pregnancy two yolk sacs were seen normally.

    CONCLUSION. The sonographic identification of yolk sacs in multiple pregnancies allows an early and efficient recognition of presence and chorionicity of twin pregnancy, both in intra – and extrauterine. Identification of abnormal yolk sac or yolk sacs suggests death of one or all embryos.

  • Very Early and Simple Determination of Chorionic and Amniotic Type in Twin Gestations by High-Frequency Transvaginal Ultrasonography

  • W. Malinowski
  • Journal:
    Acta geneticae medicae et gemellologiae: twin research / Volume 46 / Issue 3 / July 1997
    Published online by Cambridge University Press:
    01 August 2014, pp. 167-173
    Print publication:
    July 1997
    • Article
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  • Objective. The aim was to determine the chorionic and amniotic types in multifetal pregnancies with transvaginal ultrasonography at very early stage of gestation.

    Study design. Twenty-one spontaneous multifetal pregnancies were scanned transvaginally before 8 weeks' gestation (four of them from 4th week). The chorionic and amniotic type was determined ultrasonographically. All twin gestations had postpartum pathologic evaluation of the placenta and histologic determination of the chorionic and amniotic type.

    Results. Ultrasonographic evaluation of the 21 pregnancies demonstrated 20 twin and 1 triplet gestation. Four of the twin pregnancies were monochorionic-diamniotic. Triplet was monochorionic-triamniotic (spontaneously aborted in 8th week of gestation). In all 20 twin pregnancies, transvaginal ultrasonography correctly predicted the chorionic and amniotic type before 8 weeks of gestation.

    Conclusion. Transvaginal ultrasonography allows a reliable, simple and rapid determination; the dichorionic twin pregnancy in 4 weeks, monochorionic in 5 weeks, and differentiation of mono-or diamniotic in 7 weeks of gestation.