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 structures getting into the ambulatory workplace environment, obstetric sonography at a regimen point (level I) has principally been the specific sector. fresh advancements in gynecologic real-time sonography have, despite the fact that, considerably enlarged the sector of applicability of sonographic apparatus in an place of work environment. The very quick development of follicular sonography in infertility review and administration has made real-time sonography of accelerating significance to the gynecologic practitioner. In workplace settings just like the authors', gynecologic workplace sonography represents with regards to 50% of all ordered sonography. This guide of workplace sonography in obstetrics and gynecology was once conceived to mirror those alterations in perform styles. This quantity isn't really intended to switch average sonography texts for the full-time sonographer yet is as an alternative directed towards the training obstetrician/gynecologist who makes use of real-time sonography within the workplace atmosphere in the framework of day-by-day perform. Technical reviews have been hence limited to a minimal, with useful recommendation and photographic examples taking their position. many of the sonographic real-time photos have been retrieved from the authors' personal documents. notwithstanding, a few have been got throughout the generosity of buddies and associates, for which we want to increase acknowledgment and appreciation. related appreciation is prolonged to Dr. Haim Elrad and Dr. Jari Friberg, who additionally participated within the editorial approach; to Sheila Martin, who played fantastically as our editorial assistant, a so much tough accountability; and to Hilary Evans, our editor at Plenum Publishing Corporation.
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Extra info for A Practical Guide to Real-Time Office Sonography in Obstetrics and Gynecology
Among all available single-measurement dating methods, the crown-rump length is the most accurate, with an error of only ±5 days. l • Crown-rump length is obtained by measuring the longest axis of the fetus, not including the cord or yolk sac. REFERENCE I. Robinson HP, Fleming JE: A critical evaluation of sonar "crown rump length" measurements. Br J Obstet Gynaecol 1975;82:702. 56 PART I • REAL-TIME SONOGRAPHY IN OBSTETRICS FIG. 1. NORMAL GESTATIONAL SACS: 4-6 WEEKS (A) Longitudinal sector scan of a singleton gestational sac with no internal echoes.
16 REFERENCES 16. Campbell S, Diaz-Recasens J, Griffin DR, et al: New doppler technique for assessing uteroplacental blood flow. Lancet 1983;1:675. 2. The Transverse View through the Fetal Abdomen • The borders of the normal fetal liver are difficult to visualize routinely. The acoustic impedance (density difference) between bowel and liver is minimal, and therefore their borders are difficult to appreciate sonographically. • Recent advanc~s in equipment permit identification of the fetal gallbladder with greater frequency.
The Femur • The femur represents the easiest long bone to be identified (see Fig. 1). 4, and l7. 7 . ) • Femur length represents a standard parameter for fetal dating in the second and third trimesters of pregnancy. ) • Evaluation of femur length is also important for the antenatal detection of various forms of dwarfism. 2. Tibia and Fibula Tibia and fibula measurements are used by some investigators for gestational dating. These measurements also may be used for the prenatal diagnosis of dwarfism (see Fig.