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Re: SonohysterogramFrom: Philippe Jeanty (Jeanty@TheFetus.net)Tue Feb 19 07:21:00 2002
I simply use the nasogastric feeding tube and indeed I occasionally have to switch to a balloon catheter. But I think that Ruth is correct. With “straight in the line of sight uterus” there is not much that can be done to improve visualization. Wiggling the transducer does not seem to help very much. -----Original Message----- From: ultrasound@obgyn.net [mailto:ultrasound@obgyn.net]On Behalf Of Allen Worrall Sent: Monday, February 18, 2002 8:00 PM To: Multiple recipients of list ULTRASOUND Subject: Re: Sonohysterogram Ruth - I do not seem to have this problem. I use the Soules or Goldstein catheters, and only use a balloon catheter when the saline runs out as fast as we squirt it in. That is maybe one case in ten or twenty. And I am sure the Soules and Goldstein Catheters are less expensive that the balloon type. If the uterus is in the same plane as the sound beam (if you have to scan the length of the uterus, with the sound beam entering the cervix and coming out the top of the fundus), yes, that would give anyone a fit. You can try manipulating the cervix with the transvaginal transducer to see if you can get the uterus anterior or posterior. Sometimes that works. What I would do if I faced that situation and had a balloon catheter in the uterus: I would remove the transducer, done a sterile glove, and do a bimanual exam and attempt to move the uterus anterior or posterior. But with the Soules or Goldstein catheter I would not do that because there is nothing holding the catheter in the uterus and it would surely come out. Also, you may be able to see the uterus well enough through the abdomen even with an empty bladder, at least in thin women. With the balloon catheter it is worth a try. With the Soules or Goldstein, again I would worry that the catheter would come out while I was messing around changing transducers, etc. Joseph A Worrall MD RDMS OB/GYN Ultrasound at the Fairbanks Clinic Fairbanks, Alaska, USA jworrall@alaska.net <mailto:jworrall@alaska.net> www.obgynsono.com <http://www.obgynsono.com>
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