ABSTRACT
OBJECTIVE: To determine the applicability and reliability of color Doppler ultrasonography (US) for distinguishing a uterine myoma from a focal myometrial contraction. STUDY DESIGN: Images from 36 patients with uterine thickenings were classified as myomas when color Doppler US demonstrated no centralized flow with a circumscribed vessel pattern at the border. Thickenings were classified as focal myometrial contractions when there was demonstrable vascular flow throughout the thickening. RESULTS: Using these diagnostic criteria, images from 36 patients were reliably characterized as representing myomas or contractions. The diagnosis was made more reliable by using the lowest velocity settings and exclusion of power Doppler US in nonretroplacental lesions. CONCLUSION: Color Doppler US is a sensitive and reliable tool for distinguishing uterine myomas from focal myometrial contractions.
Subject(s)
Leiomyoma/diagnostic imaging , Pregnancy Complications, Neoplastic/diagnostic imaging , Ultrasonography, Prenatal/standards , Uterine Contraction , Uterine Neoplasms/diagnostic imaging , Adult , Diagnosis, Differential , Female , Humans , Predictive Value of Tests , Pregnancy , Sensitivity and Specificity , Ultrasonography, Doppler, Color/standardsABSTRACT
BACKGROUND: Ductus arteriosus constriction is a known complication of exposure to indomethacin in utero. Nonimmune hydrops associated with indomethacin use has been reported in only six cases, all twins over 32 weeks' gestation. CASE: We present a case of fetal hydrops associated with tricuspid regurgitation and ductal constriction developing within 30 hours of instituting indomethacin tocolysis in a 28-week singleton gestation. Discontinuation of indomethacin resulted in partial resolution of these findings 72 hours later. A normal infant was delivered subsequently. CONCLUSION: Ultrasonographic screening for signs of constriction of the ductus arteriosus should be done within 48 hours of instituting indomethacin therapy at any gestational age.
