RESUMO
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.
Assuntos
Técnicas de Diagnóstico Obstétrico e Ginecológico , Prolapso de Órgão Pélvico/diagnóstico por imagem , Prolapso de Órgão Pélvico/patologia , Ultrassonografia/métodos , Adulto , Cistocele/diagnóstico por imagem , Cistocele/patologia , Feminino , Humanos , Pessoa de Meia-Idade , Diafragma da Pelve/diagnóstico por imagem , Diafragma da Pelve/patologia , Prolapso de Órgão Pélvico/diagnóstico , Sínfise Pubiana/diagnóstico por imagem , Sínfise Pubiana/patologia , Índice de Gravidade de DoençaRESUMO
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.
Assuntos
Endometriose/diagnóstico por imagem , Endometriose/patologia , Feminino , Humanos , Imageamento por Ressonância Magnética , Valor Preditivo dos Testes , UltrassonografiaRESUMO
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.
Assuntos
Anemia/prevenção & controle , Complicações Hematológicas na Gravidez/prevenção & controle , Resultado da Gravidez/epidemiologia , Adulto , Análise de Variância , Anemia/epidemiologia , Índice de Apgar , Estudos de Casos e Controles , Estudos de Coortes , Países em Desenvolvimento , Feminino , Morte Fetal/epidemiologia , Morte Fetal/etiologia , Retardo do Crescimento Fetal/epidemiologia , Retardo do Crescimento Fetal/etiologia , Hemoglobinas/análise , Humanos , Mortalidade Infantil , Recém-Nascido , Modelos Logísticos , Mães/educação , Mães/estatística & dados numéricos , Trabalho de Parto Prematuro/epidemiologia , Trabalho de Parto Prematuro/etiologia , Paquistão/epidemiologia , Gravidez , Complicações Hematológicas na Gravidez/epidemiologia , Prevalência , Fatores de Risco , Fatores SocioeconômicosRESUMO
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
