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3 results

  • Chapter 3 - Imaging in Gynaecological Practice

  • from Section 1 - Basic Sciences in Gynaecology
  • Edited by Tahir Mahmood, Charles Savona-Ventura, Ioannis Messinis, Sambit Mukhopadhyay
  • Book:
    The EBCOG Postgraduate Textbook of Obstetrics & Gynaecology
    Published online:
    24 November 2021
    Print publication:
    02 December 2021, pp 15-31

  • Summary

    Imaging is an indispensable diagnostic tool in gynaecological practice. Transvaginal ultrasound (TVS) is most often used in an office environment as an adjunct to clinical examination. Transabdominal ultrasound is employed in specific applications and often as a first step before TVS by non-gynaecologists, while MRI and CT are used selectively as secondary tests for specific indications. Perioperative imaging is increasingly popular in clinical practice. In the first section, the essentials of the ultrasound technique and image optimization skills will be described as well as professional attributes necessary for safe ultrasound practice. In the clinical section, the prescribed approach was based on presenting symptoms as is the case in clinical practice where patients are referred or present themselves with a complaint. It is critical for ultrasound practitioners to accurately recognize normal features easily and, likewise, in the differential diagnosis of abnormal findings, they should master the salient features that will ultimately establish a diagnosis.

  • Chapter 7 - Placental Abnormalities

  • from Part I - ANTEPARTUM
    • By Karen W. Green, Associate Professor Obstetrics and Gynecology, University of Massachusetts Medical Center Worcester, Massachusetts, Matthew A. Esposito, Assistant Professor, Department of Obstetrics and Gynecology University of Massachusetts Medical Center Worcester, Massachusetts
  • John Patrick O'Grady, Tufts University, Massachusetts, Martin L. Gimovsky, Lucy A. Bayer-Zwirello, Kevin Giordano
  • Book:
    Operative Obstetrics
    Published online:
    07 May 2010
    Print publication:
    04 August 2008, pp 145-175

  • Summary

    Obstetric complications secondary to placental dysfunction can occur at any point in gestation. Improvements in perinatal diagnostic techniques such as focused ultrasound studies of fetal growth, placental blood flow, and fetal/placental anatomy now permit the identification of certain complications related to poor implantation or abnormal early development that can be linked to placental function. Confusion caused by the potential overlap in history and physical findings with the various placental abnormalities has led physicians in recent years to rely heavily on ultrasound scanning to help in identifying the cause of ante- and intrapartum hemorrhage. With the known association of placenta previa and prior cesarean delivery with placenta accreta, and an ever-increasing rate of cesarean delivery, there has been a recent focus on identifying ultrasound findings predictive of abnormal placenta adherence. Placental abnormalities can lead to maternal adverse outcomes such as hemorrhage requiring transfusion, more extensive surgery, emotional consequences, and even death.

  • An Assessment of Perinatal Mortality in Twin Pregnancies in Dundee

  • G.K. Osbourne, N.B. Patel
  • Journal:
    Acta geneticae medicae et gemellologiae: twin research / Volume 34 / Issue 3-4 / October 1985
    Published online by Cambridge University Press:
    01 August 2014, pp. 193-199
    Print publication:
    October 1985
    • Article
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  • An analysis of all perinatal deaths occurring in twin pregnancies in Dundee women from 1956 to 1983 was performed. The uncorrected perinatal mortality rate fell from 116/1000 births in 1956-60 to 16/1000 births in 1981-83, this fall almost entirely taking place after 1975. Causes of death were identified using the Aberdeen Classification and a reduction in deaths in all cause groupings occurred. About half of the deaths were in the Premature, Cause Unknown group and a marked decrease in deaths in this group made the largest contribution to the improved perinatal mortality rate. This fall was partly due to a reduction in the incidence of extreme prematurity and low birth weight. Changes in obstetric management which may have influenced outcome included the introduction of routine early pregnancy ultrasound scanning, the use of tocolytic drugs, intrapartum fetal monitoring, epidural analgesia and an increase in Caesarean section rate from 2% in 1956-60 to 39% in 1981-83.