Sonographic Diagnosis of Velamentous and Marginal Placental Cord Insertion.

Routine second trimester ultrasound (US) examinations include an assessment of the umbilical cord given its vital role as a vascular conduit between the maternal placenta and fetus during fetal development. Placental cord insertion abnormalities can be identified during prenatal US screening and are increasingly recognized as independent risk factors for various complications during pregnancy and delivery. The purpose of this pictorial review is to illustrate examples of velamentous and marginal placental cord insertion with an emphasis on how to differentiate their morphology using color Doppler US.

Cesarean scar ectopic pregnancy: imaging features, current treatment options, and clinical outcomes.

PURPOSE: Cesarean scar ectopic pregnancy (CSEP) is considered to be quite rare, but the frequency is increasing given the increasing number of cesarean sections being performed, along with increased detection due to widespread use of early endovaginal sonography. The normal sonographic and magnetic resonance findings of this phenomenon will be discussed, including the appearance of complications associated with abnormal placentation, such as the placenta accreta spectrum. Cases of CSEP at our institution will be illustrated, along with clinical presentations and treatment outcomes. METHODS: The study included women who were diagnosed with a CSEP in the first trimester, which was confirmed by ultrasound. The clinical presentations, imaging findings, and treatment outcomes of these pregnancies were recorded. RESULTS: In our series, treatment ranged from no intervention with fetal demise on short-term follow-up ultrasound to viable near-term deliveries requiring cesarean section, urgent blood products, and emergent surgery. The majority of our cases 75% (15 of 20) underwent successful early first trimester termination by a combination of systemic methotrexate administration, ultrasound-guided injection of embryocidal agents, and/or surgery. CONCLUSION: Early imaging recognition and diagnosis of CSEP is critically important to minimize maternal complications, maintain treatment options, and potentially preserve future fertility.

Cesarean scar pregnancy: sonographic and magnetic resonance imaging findings, complications, and treatment.

A cesarean scar (ectopic) pregnancy occurs when a pregnancy implants on a cesarean scar. This condition is an uncommon but potentially devastating occurrence. The incidence is increasing as cesarean deliveries become more common. Early recognition of the salient sonographic findings is critical because a delay can lead to increased maternal morbidity and mortality. Magnetic resonance imaging is a valuable troubleshooting tool when sonography is equivocal or inconclusive before therapy or intervention. Early diagnosis by sonography directs therapy and improves outcomes by allowing preservation of the uterus and future fertility. We review the imaging features, differential diagnosis, complications, and treatment of cesarean scar pregnancies in the first trimester.

The role of ultrasound in the diagnosis of cyclosporine toxicity in renal transplantation

Este estudio analiza 17 pacientes que recibieron 22 transplantes de riñones tratados con ciclosporina como imunosupresión básica. Todos los episodios de toxicidad con ciclosporina fueron analizados desde el punto de vista clínico y del laboratorio, incluyendo estudios de ultrasonido, renogramas y biopsias renales. Estos estudios correñacionaron bien con las dosis de ciclosporina y las concentraciones séricas de la droga. Es posible concluir que un ultrasonido renal normal, con un renograma indicativo de insuficiencia renal aguda, y valores altos de creatinina sérica, son compatibles con toxicidad por la ciclosporina