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 distinctive region. fresh advancements in gynecologic real-time sonography have, besides the fact that, considerably enlarged the sector of applicability of sonographic gear in an workplace atmosphere. The very quick progress 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 just about 50% of all ordered sonography. This guide of workplace sonography in obstetrics and gynecology used to be conceived to mirror those adjustments in perform styles. This quantity isn't intended to exchange ordinary sonography texts for the full-time sonographer yet is in its place directed towards the training obstetrician/gynecologist who makes use of real-time sonography within the workplace environment in the framework of day-by-day perform. Technical reviews have been accordingly constrained to a minimal, with functional recommendation and photographic examples taking their position. lots of the sonographic real-time pictures have been retrieved from the authors' personal records. although, a few have been bought throughout 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 technique; 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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Extra resources for A Practical Guide to Real-Time Office Sonography in Obstetrics and Gynecology
Manipulation of the fetus into a back-up position or different transducer angulations should permit identification of the opposite kidney. • With the fetus in a spine-up or spine-down position, both kidneys can easily be identified just lateral to the fetal spine (see Fig. 1). • Both kidney circumferences should not occupy more than one-third of the total abdominal circumference. If they occupy more than one-third of the abdomen, fetal urinary tract abnormalities have to be ruled out. ) • It is important to identify a centrally located renal pelvis that will have the sonographic appearance of a more echo-dense area than the surrounding cortex.
44 THE PLACENTA Placental Anatomy • The chorionic plate, whenever clearly visible, should represent an increased linear echogenic structure running uninterrupted at the fetal side of the placenta. • 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.
3. The Fetal Stomach • Localization of the fetal stomach serves as a landmark for identifying the left side of the fetal abdomen, except in the situation of situs inversus (see Fig. 3). • Visualization of a normal fetal stomach at 20 weeks gestational age supports the presence of a normal fetal swallowing mechanism. • Failure to visualize the stomach may result from normal emptying of the stomach or fetal regurgitation. Consequently, a repeat scan after 30 min should be obtained. • Variations in normal stomach size may be extensive.
A Practical Guide to Real-Time Office Sonography in Obstetrics and Gynecology by Robert V. Giglia R.T., R.D.M.S., Kara L. Mayden R. T., R.D.M.S., Norbert Gleicher M. D. (auth.)