Deborah Wye

Transperineal use of a pocket‐sized ultrasound machine versus conventional transvaginal ultrasound: A blinded comparison of cervical length in pregnancy

Spontaneous preterm birth is a leading cause of neonatal mortality and morbidity and its prediction remains a particular challenge in obstetrics1. Measurement of sonographic cervical length (CL) is a useful aid in managing women at risk of preterm labor and assisting in the effective use of healthcare resources. CL measurement by transvaginal sonography (TVS) is considered to be the ‘gold standard’, however, in cases in which there may be clinical or patient reluctance, transperineal (TPS)/translabial sonography can be offered as an alternative. Previous studies have demonstrated good correlation between the measurement of CL using TPS and TVS approaches, however, in these studies, ultrasound examinations were performed using high-specification ultrasound machines (HSUM), with a curvilinear ultrasound probe2–4. Pocket-sized ultrasound machines (PUM) have attracted interest recently due to their portability and affordability. They can provide a simple ultrasound service at the bedside, especially in remote locations or low-resourced communities5. Currently, however, a TVS probe is not provided with PUM units. If the PUM method, using TPS, is proven to be feasible and comparable to HSUM TVS, it may enable CL measurement in a point-of-care setting. Here we present our study, in which we evaluated the feasibility and accuracy of TPS measurement of CL with a PUM, in a blinded comparison with conventional HSUM TVS. This was a prospective, observational cohort study of 113 non-consecutive pregnant women, who required TVS at 11–40 weeks’ gestation as part of their clinical management. All women gave consent to undergo conventional HSUM TVS followed by PUM TPS for measurement of CL. HSUM TVS was performed by a qualified sonographer and PUM TPS was performed by one of the study investigators, also a qualified sonographer or sonologist, who was blinded to the indication for the ultrasound examination and the TVS findings. The PUM had a 1.7–3.8-MHz phased array transducer with a 13 × 19 mm Figure 1 Ultrasound images in a patient with a short cervix, using: (a) high-specification ultrasound machine with transvaginal sonography (HSUM) and (b) pocket-sized ultrasound machine with transperineal sonography (PUM). Calipers are placed at internal os (left caliper) and external os (right caliper). Cervical length on HSUM was 1.37 cm (a) and on PUM was 1.4 cm (b).

Transperineal use of a pocket-sized ultrasound machine vs conventional transvaginal ultrasound: a blinded comparison of cervical length in pregnancy.

Spontaneous preterm birth is a leading cause of neonatal mortality and morbidity and its prediction remains a particular challenge in obstetrics1. Measurement of sonographic cervical length (CL) is a useful aid in managing women at risk of preterm labor and assisting in the effective use of healthcare resources. CL measurement by transvaginal sonography (TVS) is considered to be the ‘gold standard’, however, in cases in which there may be clinical or patient reluctance, transperineal (TPS)/translabial sonography can be offered as an alternative. Previous studies have demonstrated good correlation between the measurement of CL using TPS and TVS approaches, however, in these studies, ultrasound examinations were performed using high-specification ultrasound machines (HSUM), with a curvilinear ultrasound probe2–4. Pocket-sized ultrasound machines (PUM) have attracted interest recently due to their portability and affordability. They can provide a simple ultrasound service at the bedside, especially in remote locations or low-resourced communities5. Currently, however, a TVS probe is not provided with PUM units. If the PUM method, using TPS, is proven to be feasible and comparable to HSUM TVS, it may enable CL measurement in a point-of-care setting. Here we present our study, in which we evaluated the feasibility and accuracy of TPS measurement of CL with a PUM, in a blinded comparison with conventional HSUM TVS. This was a prospective, observational cohort study of 113 non-consecutive pregnant women, who required TVS at 11–40 weeks’ gestation as part of their clinical management. All women gave consent to undergo conventional HSUM TVS followed by PUM TPS for measurement of CL. HSUM TVS was performed by a qualified sonographer and PUM TPS was performed by one of the study investigators, also a qualified sonographer or sonologist, who was blinded to the indication for the ultrasound examination and the TVS findings. The PUM had a 1.7–3.8-MHz phased array transducer with a 13 × 19 mm Figure 1 Ultrasound images in a patient with a short cervix, using: (a) high-specification ultrasound machine with transvaginal sonography (HSUM) and (b) pocket-sized ultrasound machine with transperineal sonography (PUM). Calipers are placed at internal os (left caliper) and external os (right caliper). Cervical length on HSUM was 1.37 cm (a) and on PUM was 1.4 cm (b).

Sonographic diagnosis of spontaneous uterine rupture at the site of cornual wedge resection scar – a case report

Introduction: Uterine rupture and uterine dehiscence during pregnancy are known complications of a scarred uterus. Spontaneous uterine rupture at the site of prior cornual wedge resection has been previously reported in the literature, however remains rare.

Effect of three‐ vs four‐dimensional ultrasonography on maternal attachment

Maternal attachment begins its course during early pregnancy with thoughts and feelings for the unborn baby gradually increasing and attachment intensifying in the first weeks after birth of the baby.1.

EP03.01: Interclass observer reliability in measuring uterocervical angle: Electronic Poster Abstracts

A retrospective study was conducted on 200 women who attended the Perinatal Ultrasound Department for their fetal anatomy ultrasound between 18 and 22 weeks of gestation. A transvaginal examination is offered to assess the cervical length with this ultrasound. Four independent investigators were asked to measure the uterocervical angle. Retrospective angle measurements were obtained using Viewpoint 4D software. The angle is formed by the cervix and the anterior lower uterine segment (Image 1). The 4 raters were evaluated for consistency of measurement and summarised with an inter-class correlation index (Table 1). Table 1 Conclusion

Screening the second-trimester fetal heart in women with an increased body mass index using three-dimensional volume sweep

To determine the percentage of fetal cardiac anatomy as detailed in the International Society of Ultrasound in Obstetrics and Gynecology Practice Guidelines on sonographic screening examination of the fetal heart, which can be visualised in women with a body mass index (BMI) >30 kg/m2 using three‐dimensional (3D) volume sweeps.

The value of screening for major fetal abnormalities during the nuchal translucency examination

The nuchal translucency (NT) scan provides an opportunity to examine fetal anatomy. Current opinion on the advantages and limitations of assessing fetal anatomy at this early gestation is divided. Two case studies from our centre will be presented where assessing fetal anatomy was of great benefit – one in finding abnormalities, the other in excluding them.