ABSTRACT
INTRODUCTION AND HYPOTHESIS: We determined the relationship between clinical assessment of female pelvic organ prolapse (POP) using the validated Pelvic Organ Prolapse Quantification (POP-Q) and dynamic 2D transperineal ultrasound (TPUS). METHODS: Women attending the urogynecology clinics between July and October 2009 were recruited. Prolapse was assessed using the POP-Q. Points Ba, Bp and C (anterior, posterior and middle compartments, respectively) were measured. TPUS was performed at maximum Valsalva by another clinician. As the TPUS probe compresses the prolapse that extends beyond the hymen, these women were excluded. A reference line was drawn parallel to the inferoposterior margin of the pubic symphysis, perpendicular to which the leading edge of descent was measured. The offset measured from the curved array of the probe to the reference line was added to the prolapse quantification on ultrasound (US) scan to make it objectively comparable with the POP-Q reference of the hymen. Points Ba, Bp and C on POP-Q were then compared with points of maximum descent achieved on TPUS. RESULTS: One hundred and fifty-eight women had a POP-Q and TPUS; 20 scans (12.6 %) were not analysable, and 41 women had prolapse beyond the hymen. Ninety-seven women were thus analysed. The correlation between 2D TPUS (with/without the addition of the offset) and POP-Q was statistically significant (p value <0.0001) for all three compartments. The proportion of correct predictions was 59.6 %, 61.5 % and 32.6 % for bladder, bowel and middle-compartment prolapse, respectively. CONCLUSION: These findings suggest that the accuracy of pelvic floor US staging is limited and that clinical assessment remains the gold standard.
Subject(s)
Diagnostic Techniques, Obstetrical and Gynecological , Pelvic Organ Prolapse/diagnostic imaging , Pelvic Organ Prolapse/pathology , Ultrasonography/methods , Adult , Cystocele/diagnostic imaging , Cystocele/pathology , Female , Humans , Middle Aged , Pelvic Floor/diagnostic imaging , Pelvic Floor/pathology , Pelvic Organ Prolapse/diagnosis , Pubic Symphysis/diagnostic imaging , Pubic Symphysis/pathology , Severity of Illness IndexABSTRACT
Adenomyosis has been an elusive diagnosis until recently due to the need for a histological confirmation of diagnosis post-hysterectomy. This commentary focuses on the role of non-invasive imaging techniques that have become available for use in the diagnosis of adenomyosis in women with an intact uterus. These include magnetic resonance imaging (MRI) and transvaginal ultrasound (TVS). With improvements in imaging modalities it has now become feasible to establish a diagnosis of adenomyosis without hysterectomy, to exclude additional pathology and to institute conservative symptomatic treatment and monitoring.
Subject(s)
Endometriosis/diagnostic imaging , Endometriosis/pathology , Female , Humans , Magnetic Resonance Imaging , Predictive Value of Tests , UltrasonographyABSTRACT
Maternal anaemia is a common problem in pregnancy, particularly in developing countries. We investigated the relationship between maternal anaemia and perinatal outcome in a cohort of 629 pregnant women from October 2001 to 2002. Of these, 313 were anaemic (haemoglobin < 11 g/L). Perinatal outcomes included preterm delivery, low birth weight, intrauterine growth retardation, perinatal death, low Apgar scores and intrauterine fetal death. Univariate and multivariate analyses were performed. The risk of preterm delivery and low birth weight among the anaemic women was 4 and 1.9 times more respectively than the non-anaemic women. The neonates of anaemic women also had 1.8 times increased risk having low Apgar scores at 1 minute and there was a 3.7 greater risk of intrauterine fetal death among the anaemic women than the non-anaemic women.
Subject(s)
Anemia/prevention & control , Pregnancy Complications, Hematologic/prevention & control , Pregnancy Outcome/epidemiology , Adult , Analysis of Variance , Anemia/epidemiology , Apgar Score , Case-Control Studies , Cohort Studies , Developing Countries , Female , Fetal Death/epidemiology , Fetal Death/etiology , Fetal Growth Retardation/epidemiology , Fetal Growth Retardation/etiology , Hemoglobins/analysis , Humans , Infant Mortality , Infant, Newborn , Logistic Models , Mothers/education , Mothers/statistics & numerical data , Obstetric Labor, Premature/epidemiology , Obstetric Labor, Premature/etiology , Pakistan/epidemiology , Pregnancy , Pregnancy Complications, Hematologic/epidemiology , Prevalence , Risk Factors , Socioeconomic FactorsABSTRACT
Maternal anaemia is a common problem in pregnancy, particularly in developing countries. We investigated the relationship between maternal anaemia and perinatal outcome in a cohort of 629 pregnant women from October 2001 to 2002. Of these, 313 were anaemic [haemoglobin < 11 g/L]. Perinatal outcomes included preterm delivery, low birth weight, intrauterine growth retardation, perinatal death, low Apgar scores and intrauterine fetal death. Univariate and multivariate analyses were performed. The risk of preterm delivery and low birth weight among the anaemic women was 4 and 1.9 times more respectively than the non-anaemic women. The neonates of anaemic women also had 1.8 times increased risk having low Apgar scores at 1 minute and there was a 3.7 greater risk of intrauterine fetal death among the anaemic women than the non-anaemic women
