Donald School Journal of Ultrasound in Obstetrics and Gynecology

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VOLUME 3 , ISSUE 3 ( July-September, 2009 ) > List of Articles

REVIEW ARTICLE

Primary Care in Obstetrics and Gynecology — A Place for Advanced Ultrasound?

Ulrich Honemeyer

Keywords : Adnexal mass,power Doppler,transvaginal ultrasound,saline infusion sonohysterography,obstetric ultrasound screening,primary care

Citation Information : Honemeyer U. Primary Care in Obstetrics and Gynecology — A Place for Advanced Ultrasound?. Donald School J Ultrasound Obstet Gynecol 2009; 3 (3):61-74.

DOI: 10.5005/jp-journals-10009-1022

License: CC BY-NC 4.0

Published Online: 01-06-2010

Copyright Statement:  Copyright © 2009; The Author(s).


Abstract

The evaluation of adnexal masses based on transvaginal sonography (TVS) and when their size is too big- transabdominal US can be facilitated and refined by using color Doppler (CD), power Doppler (PD), and pulsed Doppler(PW), including three-dimensional ultrasound (3D US). With these modes, we obtain information about vascularity and flow indices, and their distribution within a mass. Considering the fact that neoangiogenesis is a main feature of malignancy, this is essential information. Thus, we are able to assume the benign or malignant character of an adnexal mass, make the right choice of additional imaging or biochemical tests, and then channel the treatment appropriately. This is subsequently demonstrated for simple cyst, hemorrhagic cysts, endometrioma, dermoid, serous papillary cystoma, ectopic pregnancy, and ovarian carcinoma.

Abnormal uterine bleeding (AUB) is a common problem in primary care. Compared to transabdominal approach, TVS improves the detection rate of underlying uterine pathology. In conditions like endometrial hyperplasia, polyps, submucous leiomyoma, and endometrial cancer, CD, PD, PW and contrast enhanced transvaginal ultrasound may optimize sonographic evaluation. Saline infusion sonohysterography (SISH) in out patient department (OPD) is an alternative to invasive diagnostic hysteroscopy in patients with AUB.

Care for maternal and fetal well-being during pregnancy is a main task in OPD. The assessment of fetal pathology is almost entirely based on Ultrasound. Several illustrations of fetal anomalies detected during 1st trimester and 2nd trimester screening, of abnormal findings in feto-maternal Doppler ultrasound, and fetal pathology demonstrated in 3D/4D ultrasound mode, conclude this review of advanced ultrasound in primary care.

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