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Objective To evaluate the value of transvaginal ultrasound in diagnosing intrauterine adhesions.Methods Transvaginal ultrasound was performed in 136 patients with suspicious intrauterine adhesions and compared with hysteroscopy correspondingly .The ultrasonographic features of intrauterine adhesions on transvaginal ultrasound were summarized .Results One hundred and twenty one cases (89.0%, 121/136 ) of intrauterine adhesions were verified by hysteroscopy .The hysteroscopic findings included:(1) Forty seven cases(38.9%,47/121) were minimal intrauterine adhesions , 46 cases(38.0%, 46/121) were moderate intrauterine adhesions , and 28 cases (23.1%,28/121) were severe intrauterine adhesions.(2) Sixty one cases(50.4%,61/121) were central intrauterine adhesions , 24 cases(19.8%, 24/121) were marginal intrauterine adhesions , and 36 cases (29.8%, 36/121) were mixed type of intrauterine adhesions.The transvaginal ultrasound findings included:(1)Nineteen cases(40.4%,19/47) were minimal intrauterine adhesions ,33 cases(71.7%,33/46)were moderate intrauterine adhesions ,and 23 cases(82.1%,23/28) were severe intrauterine adhesions .(2) Thirty nine cases (63.9%,39/61) were central intrauterine adhesions ,9 cases(37.5%,9/24) were marginal intrauterine adhesions ,and 27 cases (75.0%, 27/36 ) were mixed type of intrauterine adhesions .By transvaginal ultrasound, seventy-five (62.0%,75/121) cases of intrauterine adhesions were correctly diagnosed , whereas 46 cases (38.0%, 46/121) were missed.And 3 cases ( 3.8%, 3/78 ) were misdiagnosed as intrauterine adhesions on transvaginal ultrasound,including one endometrial polyp ,one thin endometrium and one septate uterus .The sensitivity, specificity and accuracy of transvaginal ultrasound in diagnosing intrauterine adhesions were 62.0%(75/121), 80.0%(12/15) and 64.0%(87/136) respectively.There were significant statistical differences in diagnosing different degrees of intrauterine adhesions ( χ2 =15.956,P=0.000) and different parts of intrauterine adhesions( χ2 =8.792,P=0.012) by transvaginal ultrasound.Conclusions Transvaginal ultrasound is an effective, easy to perform and noninvasive technique in screening and diagnosing intrauterine adhesions.Transvaginal ultrasound is an effective way in diagnosing intrauterine adhesions showing a noninvasive and simpler way than hysteroscopy .Transvaginal ultrasound is of great value in screening and diagnosing intrauterine adhesions .
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Objective To summarize the ultrasonographic features and differential diagnosis of uterine cornual pregnancy.Methods Trans-abdominal and trans-vaginal ultrasound were performed in 93 uterine cornual pregnancy patients before surgery,ultrasonographic findings of uterine cornual pregnancy through different two approaches were analyzed and compared with surgical and pathologic findings.ResultsIn contrast with surgical and pathological diagnosis,66 cases(82.5%,66/80) of uterine cornual pregnancy were accurately diagnosed by ultrasonography before surgery,these cases were divided into gestational sac pattern (55 cases) and mixed mass pattern(11 cases); 11 cases were misdiagnosed as interstitial tubal pregnancy,2 cases were misdiagnosed as pregnancy in rudimentary horn,1 case was misdiagnosed as choriocarcinoma,misdiagnosed rate were 17.5%(14/80); uterine cornual pregnancy presented as adnexal mass in ultrasound in 13 cases,while ruptured uterine cornual mass were found in surgery,in which location and type of the masses couldn't be accurately diagnosed by ultrasound.Ultrasonographic features of uterine cornual pregnancy presented as a gestational sac located in extended cornual of uterus,surrounded by thin myometrium,and connected with endometrium.The misdiagnosed causes were: (1) Uterine cornual mass was not connected with endometrium or surrounded by thin myometrium,which were misdiagnosed as interstitial tubal pregnancy.(2) Uterine cornual pregnancy with thick lateral myometrium were misdiagnosed as pregnancy in rudimentary horn.(3)Uterine cornual pregnancy presented as cornual mass with abundant blood flow was misdiagnosed as choriocarcinoma.Conclusions Uterine cornual pregnancy can be accurately diagnosed by trans-abdominal and trans-vaginal ultrasound.Ultrasonographic features are helpful in differential diagnosis of uterine cornual pregnancy.
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<p><b>OBJECTIVE</b>To evaluate the perinatal management and outcome of different types of fetal arrhythmia.</p><p><b>METHODS</b>A retrospective analysis was conducted among the fetuses with arrhythmia identified by M-mode and pulsed Doppler echocardiography in a single institution between October 2003 and December 2010.</p><p><b>RESULTS</b>A total of 130 fetuses were found to have fetal arrhythmia. The most common arrhythmia during pregnancy was extrasystole (n=59), followed by bradycardia (n=23), tachycardia (n=16), atrial flutter (AF, n=3), atrioventricular block (AVB, n=12) and other arrhythmia (n=17). The overall incidence of cardiac anomalies (commonly fetal bradycardia) was 9.2% in these cases. The prognosis of arrhythmia differed significantly between cases of different classifications. The type of fetal arrhythmia (P=0.024), presence of congenital heart defect (CHD, P=0.000) and fetal hydrops (P=0.008) were significant risk factors associated with termination of pregnancy.</p><p><b>CONCLUSION</b>Fetal arrhythmias without CHD or hydrops under close monitoring often have good clinical outcome, while fetal bradycardia is associated with a high mortality rate. CHD and the presence of fetal hydrops are significant risk factors for pregnancy termination.</p>
Subject(s)
Adult , Female , Humans , Pregnancy , Young Adult , Arrhythmias, Cardiac , Classification , Diagnostic Imaging , Fetal Diseases , Diagnostic Imaging , Heart Defects, Congenital , Diagnostic Imaging , Pregnancy Trimester, Second , Pregnancy Trimester, Third , Retrospective Studies , Ultrasonography, Doppler, Color , Ultrasonography, PrenatalABSTRACT
Objective To investigate the effects of different standard cross sections and angles on the measurement accuracy of induced postnatal fetal long bones. Methods Fetal long bones (femori and humeri) in 30 cases with induced abortion were measured utilizing ultrasound from different angles and /or at different directions. The values measured from different sections and angles with vernier calipers were compared prenatally and postnatally. Results There was no apparent difference between the pre-induced abortion and those of the post-induced abortion. The results in the 30 cases showed that: (1) the values measured from anterior 90 degree, the long bone length would best match with the bare long bone length up to 96.7%, the match rate of other angles and/or directions was up to 80%; (2) no apparent statistical difference was between the length of left and right bone and no difference was found using 4 different directions and 3 different angles; (3)there was no difference between the left and right femuri and humeri.Conclusions Though the measured value from anterior 90 degree direction was the most accurate one, the statistical analtical results showed no difference among 12 values measured from 3 different angles and/or 4 different directions.
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<p><b>OBJECTIVE</b>To study the value of prenatal ultrasound in the diagnosis of fetal malformations.</p><p><b>METHODS</b>We retrospectively analyzed the clinical data of 993 cases of neonates and induced babies with malformations who were labored in our hospital from January 1999 to October 2006.</p><p><b>RESULTS</b>The incidence rate of fetal malformation was 22.5 per thousand in our study group. The detection rate of prenatal ultrasound was 79.02% (1 062/1 344), among which the detection rate of the severe malformations (87.58%, 860/982) were significantly higher than that of the minor malformations (55.80%, 202/362) (P < 0.005). The false negative rate was high for the extremity malformations (39.46%) and facial malformations (31.91%), especially the acrosclerodermas, simple cleft palates, and ear deformities.</p><p><b>CONCLUSION</b>Prenatal ultrasound is sensitive for fetal severe malformations, while the detection rate is low for fetal minor malformations.</p>
Subject(s)
Humans , Congenital Abnormalities , Diagnostic Imaging , False Negative Reactions , Retrospective Studies , Ultrasonography, PrenatalABSTRACT
Objective To investigate the expression of Apelin in placenta tissue from women with hypertensive disorders complicating pregnancy.Methods Thirty six women with hypertensive disorders complicating pregnancy(HDCP)and 15 normal pregnant women were studied.The expression of Apelin-36 was analyzed semi-quantitatively using immunohisto-chemistry and image analysis in placenta tissue and the levels of Apelin mRNA expression were determined by real-time quantitative RT-PCR method.Results The levels of Apelin-36 and Apelin mRNA in placenta from normal pregnant women were 0.27?0.04 and 0.82 ?0.25,respectively.The levels of Apelin-36 and Apelin mRNA in placenta from HDCP women were 0.18 ?0.05 and 0.31?0.21;in gestational hypertensive women,the values were 0.24?0.02 and 0.59?0.16; in mild preeclampsia were 0.16?0.03 and 0.25?0.07,and in severe preeclampsia they were 0.14?0.02 and 0.17?0.09,respectively.The levels of Apelin-36 and Apelin mRNA in HDCP were lower than those in normal pregnant women(P