Transvaginal sonography in the evaluation of hematometra. A report of two cases.

BACKGROUND: Transabdominal sonography is useful in the diagnosis of hematometra but may not provide information as to its cause. CASES: Two cases of postmenopausal bleeding were evaluated using both transabdominal and transvaginal sonography. Transabdominal sonography detected the presence of hematometra; transvaginal sonography detected the neoplastic lesions responsible for the hematometra. CONCLUSION: Transvaginal sonography is important in the evaluation of hematometra because it affords clear visualization of the endometrial cavity.

Ambulatory tocodynamometry data interpretation: evaluating variability and reliability.

The inter- and intra-observer variabilities of interpretation of uterine activity monitoring data were determined from the interpretations of 20 ambulatory tocodynamometry records by nine physicians and nurses. The presence of contractions lasting less than 40 seconds or presenting at a frequency of fewer than four per hour was associated with significantly reduced accuracy of interpretation. The reliability was 70% with one observer, 82% with two observers, and 88% with three observers. Higher variability and lower reliability values were obtained for interpretation of low-amplitude, high-frequency contractions. Understanding the limitation of uterine activity data interpretation should help in the clinical management of monitored patients.

A new technique for reduction of prolapsed fetal membranes for emergency cervical cerclage.

A new method to replace fetal membranes that have prolapsed through an incompetent cervix, which includes overfilling of the urinary bladder, was successful in four consecutive patients who presented with this clinical entity.