feasibility of trans vaginal sonographic cervical changes for the diagnosis of cervical incompetence

Sixty seven pregnant women at risk of developing cervical incompetence and 20 control pregnant women were examined prospectively by transvaginal sonography [TVS] to differentiate between the competent and the incompetent cervices. Patients were divided in to 5 groups based on method of diagnosis. Means and standard deviations for ultrasound measurements showed highly significant differences between all prediagnotic and postdiagnostic measurements as well as between all prettereatment and postreatment measuremenets [P < 0.001]. By combined clinical and ultrasound criteria 38 [56.7%] patients were identified as having cervical incompetence and 29 [43 3%] patients were saved unnecessary cerclage

Transvaginal sonography [TVS] f or assessement of tubal patency

Assessement of tubal patency using the transvaginal ultrasound was performed in 24 infertile patients. We used a new technique which combines and modifies both the techniques of sonosalpingography of Richman et al. [1984] who have studied tubal patency following fluid injection using transabdominal sonography and the foley catheter techniques [FCT] of David et al [1979] for injecting a contrast media into the uterine cavity during HSG via a foley catheter instead of the traditional metallic cannula. We only consider flow of fluid in the cue-dc-sac seen as turbulence as an indicaticn of at least unilateral tubal patency. We compared our results with the findings obtained by HSG and/or Laparoscopy done for the same patients. We found That tubal patency test by TVS has a sensitivity of 100%, specificity 96% and accuracy of 98%. Transvaginal sonography for assessment of tubal patency is safe, more convenient and provide a reliable method for screening pelvic anatomy

Laparoscopy, hysteroscopy and fluorscopically monitored hysterosalpingography in evaluation of female infertility

The diagnostic accuracy of 1aparoscopy hysteroscopy and fluoroscopically monitored hysterosalpingography [HSG] were evaluated in 80 infertile women who underwent these procedures as part of their infertility work-up. HSG versus laparoscopy in evaluation of the tuboperitoneal factor showed 64.44% sensitivity and 85,71% specificity with diagnostic efficacy of 73.75%. HSG versus hysteroscopy in evaluation of the uterine factor showed 69.56% sensitivity and 87.71% specificity with diagnostic efficacy of 82.5% These data indicates that for optimal evaluation, a combiend approach using the three procedures is recommended. The clinical history. suggestive symptoms together with physical examination should provide a base for more selective use of these diagnostic techniques