Warwick Birrell

A standardised ultrasonic diagnosis and an accurate prevalence for the retroverted uterus in general gynaecology patients

Transvaginal ultrasound with an empty bladder is recommended as a standardised ultrasonic technique for the accurate diagnosis of the retroverted uterus. Using this method, the prevalence of the retroverted uterus in 480 general gynaecological patients attending for subspecialist gynaecological ultrasound was 18%. The anteverting effect of the full bladder required for transabdominal ultrasound reduces the prevalence of the retroverted uterus to 13% (P < 0.001).

Delayed‐interval Delivery in a Quadruplet Pregnancy: The Use of Transperineal Ultrasound and Cervical Cerclage

The incidence of multiple pregnancy is increasing as a result of assisted conception. There have been several reports of delayed interval delivery, mostly with twins. We describe an interval of 4 months (111 days) in a quadruplet pregnancy, using transperineal ultrasound and a cervical suture with antibiotic and tocolytic cover. dilated. A McDonald suture was inserted that day while still under the antibiotic cover and with 100 mg indomethacin per rectum twice daily for 2 days. Metronidazole was then ceased, but the cephalosporin was continued for 4 weeks.

A preliminary anatomical basis for dual (uterosacral and sacrospinous ligaments) vaginal vault support at colporrhaphy

Introduction and hypothesisThis study aims to assess anatomically the likely effects of dual vaginal vault support using the uterosacral (USL) and sacrospinous ligaments (SSL) at colporrhaphy.MethodsObservations were made from 13 formalinized cadaver hemipelves to determine the vaginal vault support likely to be provided by traction on the (a) USLs and (b) the posterior vaginal vault towards the SSL.ResultsTraction on the USLs and SSLs both appeared to create a posterior and superior vector of vaginal vault tension, though that on the USLs appeared to be mainly on the anterior vaginal vault (and wall) with that on the SSL seemingly mostly on the posterior vaginal vault (and wall).ConclusionsConcomitant USL and SSL traction on the vaginal vault, now technically possible, appears, from these preliminary findings, to give complementary support to the anterior and posterior aspects of the vaginal vault and walls in a similar posterior and superior vector.