Ultrasonography in the diagnosis of gynecologic disorders
Article Abstract:
An evaluation is presented of the use of ultrasonography, a noninvasive technique for imaging the internal organs, to detect gynecologic disease. Older types of ultrasound equipment were primarily useful for examining the pregnant uterus and the fetus rather than the pelvic organs, but modern techniques allow clear visualization of much of the cervix, uterus, and surrounding structures. The value of ultrasound for investigating the following conditions is reviewed: pelvic masses (tumors); abnormal bleeding; pelvic pain; uterine cancer, infections in the fallopian tubes; infertility; postoperative complications; and congenital defects (abnormalities present at birth) of the reproductive system. Ultrasonography screening for early ovarian cancer has proved valuable; in one study, 5,479 women without symptoms, who were older than 44 years, underwent 14,594 screening examinations; five ovarian cancers were detected and four additional patients were found to have metastases (cancer spread). However, with a detection rate of 1 abnormality in 432 screens and 1 cancer in 1,621 screens, the costs of ultrasound screening are prohibitive. In general, ultrasonography for gynecologic diagnosis is overused; it is far more valuable as an aid to diagnosis, than as a primary diagnostic tool. Its main values are in identifying abnormal pregnancies at an early stage, in reproductive endocrinology, and in identifying pelvic masses. While ovarian cancer is a deadly disease, the number of women (over 35) who died of this disease in 1986 (11,761) was considerably less than the number who died of cancers of the breast (39,865), lung (40,350), or colon or rectum (28,172). Resources should be directed toward these conditions before they are spent on ultrasound screening for ovarian cancer. Many physicians who are not skilled ultrasonographers tend to order ultrasound examinations that would not be necessary if better patient histories were obtained and better examinations were performed. Two other articles in the April 1991 issue of the American Journal of Obstetrics and Gynecology evaluate the use of ultrasonography in obstetrics. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Obstetrics and Gynecology
Subject: Health
ISSN: 0002-9378
Year: 1991
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Antenatal diagnosis of urinary tract abnormalities by ultrasonography after 28 weeks' gestation: incidence and outcome
Article Abstract:
Fetuses with upper urinary tract dilation seen on ultrasound imaging after 28 weeks gestation should be followed up. Even symptom-free infants may have abnormalities that may cause permanent damage if left untreated after birth. Over a 5-year period, 3856 fetuses had an ultrasound scan after 28 weeks gestation for reasons unrelated to suspected urinary tract abnormality. Dilation of the upper urinary tract was noted in 7.7% of them. Dilation was transient among 72% of the group and resulted in postnatal urinary tract infections in only one child. Therefore, invasive diagnostic procedures are not recommended for this group. However, among the group with persistent dilation, 23 infants had obstruction, of which 16 required surgical correction; 14 infants had vesicoureteric reflux, of which 64% resolved by age 2; 8 infants had multicystic dysplasia of one kidney; and 3 infants had posterior urethral valves. The degree of dilation did not correspond with the likelihood of serious abnormality.
Publication Name: American Journal of Obstetrics and Gynecology
Subject: Health
ISSN: 0002-9378
Year: 1995
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Transvaginal ultrasonography in gynecologic office practice: assessment in 663 premenopausal women
Article Abstract:
Efforts to provide low cost transvaginal ultrasound examinations may increase the early diagnoses of benign and malignant gynecologic conditions. Researchers compared the results of transvaginal ultrasound examinations with results of bimanual examinations of 663 premenopausal women with symptoms of gynecologic disease. A total of 347 women were found by ultrasound to have uterine fibroids, but bimanual examination results were normal for 125 (36%). Results of surgery on the 125 women included one malignant tumor, 17 benign tumors, and two abscesses.
Publication Name: American Journal of Obstetrics and Gynecology
Subject: Health
ISSN: 0002-9378
Year: 1996
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