Contribution of spiral artery blood flow changes assessed by transvaginal color Doppler sonography for predicting endometrial pathologies

ive: To investigate the diagnostic value of blood flow measurements in spiral artery by transvaginal color Doppler sonography (CDS) in predicting endometrial pathologies.Methods: Ninety-seven patients presenting with abnormal uterine bleeding and requiring endometrial assessment were included in this prospective observational study. Endometrial thickness, structure and echogenicity were recorded. Pulsatility index (PI) and resistive index (RI) of the spiral artery were measured by transvaginal CDS. Endometrial sampling was performed for all subjects. Sonographic and hystopathologic findings were compared.Results: The histopathological diagnoses were as follows; 39 cases (40.2%) endometrial polyp, 9 cases (9.3%) endometrial hyperplasia, 10 cases (10.3) submucous myoma, 7 cases (7.2%) endometrium cancer, and 32 cases (33%) nonspecific findings. The spiral artery PI in endometrium cancer group was highly significantly lower than other groups (p<0.01). The spiral artery RI was also significantly lower in the patients with malignant histology (p<0.05). Conclusion: Endometrial pathologies are associated significantly with endometrial spiral artery Doppler changes.Key words: Spiral artery, Doppler ultrasonography, endometriu

Comparison of Modified Biophysical Profile with Doppler Ultrasonographic Analysis in Determining Fetal well Being in the Third Trimester

OBJECTIVES: In this study we aim to compare modified biophysical profile with Doppler ultrasonographic analysis in determining fetal well being in the third trimester. STUDY DESIGN: Our research is based on 99 voluntary pregnant patients ahead of 36 weeks who admitted to our hospital for labor between December 2009 and March 2010. Doppler ultrasonography and biophysical scoring were applied to all patients admitted to the study group. Following delivery, birth weight and APGAR scores of the 1st and 5th minute were noted down by the pediatrician. Prognosis and survey of all newborns admitted to the Neonatal Intensive Care Unit after delivery were closely monitored. The effectiveness of modified biophysical profile and obstetric Doppler analysis in determining the perinatal outcome was based on the evaluation of certain parameters such as; fetal distress, presence of meconium, admittance to NICU and APGAR score of the 5th minute. RESULTS: Our research is based on 99 voluntary pregnant patients between 18 and 40 years old and who are ahead of 36 weeks that were admitted to our hospital for labor between December 2009 and March 2010. Patients' median age was 23.30±4.91, gravida changing between 1 and 5 with a median of 2 and parity changing between 0 and 2 with a median of 1. Birth weight measurements varied from 2680g to 3900g with a median of 3192.22±277.42 grams. Caesarean section was performed on 20 patients (20.2%). The remaining 79 (79.8%) were delivered vaginally CONCLUSION: Modified biophysical profile was found to be a more reliable tool than Doppler analysis in determining perinatal outcome and in prediction of acute fetal distress. But combining modified biophysical profile with Doppler analysis has yielded a higher sensitivity aiding in the diagnosis of perinatal outcome and acute fetal distress. In conclusion, in order to effectively predict acute fetal distress and to maintain a reliable screening method, combined use of these tests, namely modified biophysical profile and umbilical artery Doppler analysis, has proven to be the most valuable and effective method as shown in our study

Diagnosis and clinical approach in primary ovarian ectopic pregnancy: A case report and review of the literature

Primary ovarian pregnancy is a rare type of extrauterinepregnancy with an incidence of 0.5-1% of all ectopic pregnancies.The incidence ranges from 1/40000 to 1/7000deliveries. We report a primary ovarian pregnancy in aspontaneus conception cycle in a 40-year-old womanwith no predisposing factor. The patient was admitted tothe emergency clinic with signs and symptoms of acuteabdomen with heamoperitoneum , in a preshock state. Anemergency laparotomy and wedge resection of the ovarywas performed. Histopathologic examination showedchorion villi embedded in the ovarian tissue in multiplesections in different areas of the material. This is a discussionabout this rare phenomenon, its ethiology, differentialand clinical diagnosis and a review of literature.Key words: Ectopic, pregnancy, ovar