Women's Health and Education Center (WHEC)

Diagnostic Ultrasound

List of Articles

  • Ultrasound Evaluation of Fetal Growth
    A number of interventions are available to reduce morbidity and mortality in fetuses with intrauterine growth restriction (IUGR); but these can only be implemented appropriately with timely diagnosis and monitoring. Prenatal diagnosis of these conditions can aid in decision making concerning the timing and route of delivery, thereby reducing perinatal risk. Regulation of fetal growth is multifactorial and complex. Optimal fetal development depends on genetically predetermined growth potential, and is modulated by fetal, maternal, placental, and environmental factors. The role of Doppler ultrasonography is also discussed. Abnormally small fetuses as a group have a relatively poor prognosis because some of the causes of subnormal size, such as inadequate supply of oxygen and nutrients through the placenta, chromosomal anomalies, and infections, adversely affect fetal outcome. Disturbances of fetal growth -- intrauterine growth restriction (IUGR) and macrosomia -- are associated with increased risk of perinatal morbidity and mortality. Prenatal diagnosis of these conditions can aid in decision making concerning the timing and route of delivery, thereby reducing perinatal risk.

  • Guidelines for Performance of the Obstetric Ultrasound
    The purpose of this document is to present evidence regarding methodology, indications, benefits, and risks of obstetric ultrasonography in specific clinical situations. Sections of the document addressing physician qualifications and responsibilities, documentation, quality control, infection control and patient education are the recommendations of Women's Health and Education Center (WHEC). We are hopeful that this text will serve two purposes: to educate and to intrigue. Through the education process of the healthcare providers will help alleviate errors in diagnosis. Casual use of ultrasonography, especially during pregnancy, should be avoided. Before an ultrasound examination is performed, patients should be counseled about the limitations of ultrasonography for diagnosis.

  • Sonographic Screening for Down Syndrome
    Screening for Down syndrome is an important part of routine antenatal care. Significant advances have been made in antenatal screening for Down syndrome over the past few decades. The most common screening method in the United States involves the assessment of a combination of factors: maternal age, multiple second-trimester serum markers, and second-trimester ultrasonography. More recently there has been significant interest in first-trimester methods of screening, including screening for first-trimester markers and the sonographic measurement of fetal nuchal translucency. Invasive prenatal diagnosis for Down syndrome with amniocentesis or chorionic villus sample (CVS) is offered only to women of advanced maternal age (older than 35 years at delivery) or those who previously had an affected child or to women who has abnormal multiple-marker serum screening. The most efficient multiple-marker screening test in the second trimester is the "quad" screen, comprising alpha-fetoprotein (AFP), human chorionic Gonadotropin (hCG), unconjugated estriol (E3), and Inhibin-A. This approach yields sensitivities for Down syndrome of 67-76%. The purpose of the document is to summarize the current data and shift toward first-trimester screening for Down syndrome

  • Ultrasound-guided Diagnostic Obstetrical Procedures
    Ultrasound emerged as a major tool in medical imaging in the 1970s, and its impact has been very dramatic in obstetrics. The ability of sonography to detect fetal abnormalities prior to delivery and to direct minimally invasive therapy has revolutionized the field of obstetrics. The marked improvement in ultrasound image quality in recent years and the ability to store high quality digital images and video clips have enhanced ultrasound's role in obstetrics. The purpose of this document is to discuss various diagnostic procedures available and their indications. The most commonly used ultrasound-guided diagnostic obstetrical procedures are: 1) Amniocentesis; 2) Chorionic Villus Sampling (CVS); 3) Percutaneous Umbilical Blood Sampling.

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