Kenneth R. Gottesfeld

Fetal development as determined by ultrasonic pulse echo techniques

Abstract 1. 1. The biparietal diameter has been shown, by ultrasonic methods, to increase approximately 1.8 mm. per week during the last trimester of pregnancy. 2. 2. In 68 per cent of patients, by measurement of the biparietal diameter of the fetus by the A-scan, it is possible to estimate within ± 484 grams of the actual weight of the infant. In 91 per cent, when the fetal biparietal diameter measures 8.5 cm. or more, the fetus will weigh in excess of 2,500 grams. 3. 3. Use of the calculated circumference of the fetal thorax for estimation of fetal weight gave an error of as much as 500 grams in 20 per cent. Improved techniques may eliminate much of this error. 4. 4. By using the combined estimation of biparietal diameter and chest circumference, it is possible to estimate within 400 grams of the actual weight except in large babies where the tendency is to underestimate the weight.

The ultrasonic diagnosis of intrauterine fetal death

Abstract B-mode ultrasound was used to study 113 patients for fetal death. Sixty-one were positive for death, with 2 errors early in our experience. No errors were made in the last two years (98.1 per cent accuracy). The ultrasonic diagnosis is based upon the changes in acoustical impedance following fetal death. The changes, appearing as early as 12 hours, are a coarsening of the fetal outline with collapse of fetal structures. Doppler ultrasound is used as a confirmatory adjuvant. It is felt that by combining Doppler and 2 dimensional diagnostic B-mode ultrasound the diagnosis of intrauterine fetal death can be made within 48 hours after suspected death in pregnancies more than 14 weeks and with scans a week apart if less than 14 weeks.

Ultrasound as a diagnostic aid in diseases of the pelvis

Abstract This study is an evaluation of the usefulness of pulsed echo ultrasound as a diagnostic aid in diseases of the pelvis. The results of the use of this technique in 100 patients, with suspected gynecologic lesions, are presented. Ultrasound appears to be a valuable aid when used in conjunction with other diagnostic procedures. By this method it is possible to outline and define soft tissue pathology not easily detectable by x-ray, and it provides a cross-sectional presentation, thus giving information in a different dimension than is exhibited by other techniques. This procedure is particularly helpful in differentiating between solid and cystic tumors, benign and malignant disease, and free and encysted fluid in the abdominal eavity.

Clinical use of ultrasound in obstetrics and gynecology

Abstract During the past three years ultrasound diagnostic procedures have been significant and useful aids in the clinical practice of obstetrics and gynecology at the University of Colorado Medical Center. The technique has had its most important applications in the preoperative diagnosis of hydatidiform mole, in the estimation of fetal maturity, and for localization of the placenta. Other areas of clinical application are in the diagnosis of multiple pregnancy, fetal position, and intrauterine fetal death. Approximately 10 per cent of our obstetric patients receive ultrasound diagnostic procedures. Ultrasound is used much less frequently in gynecology but does have value in the differential diagnosis of ascites, abdominal cysts, and peritoneal carcinomatosis.