Re: Ob/Gyn US practice in Asian countries
From: art fougner, md (evsono@pipeline.com)
Thu Jun 9 10:13:37 2005
Jim
i've actually found the opposite with prior sections - many patients'
uteri are axially oriented and pulled up and the upper fundus may be
outside or at the outer range of the fov. perhaps this gives credence
to the thought that cesarean may prevent future prolapse?
art
At Wed, 08 Jun 2005, James Smeltzer wrote:
>
>Hi,
>
>Sorry to disagree.... C/Sections are NOT a problem. Prior hysterectomy
>in menopausal can be better evaluated by TVS, IMHO.
>Jim Smeltaer
>
>>>> bouthina_ibrahim@yahoo.com 6/7/2005 11:19:19 PM >>>
>
>thank you so much for your ideas i think that EVS is diffcult after
>repeated CESAREAN SECTION as normal anatomy is distorted in pelvis ad
>also after hysterectomy.
>
>Tapash Bedajna <saamveda@yahoo.com> wrote:I agree with your opinion. I
>have been practicing Sonography in India for about 15 yrs and even after
>continuous endeavor I failed transvaginal study acceptable to all. Of
>course I never think of offering it to unmarried women as any sort of
>examination per vagina in unmarried is unlawful in India. The matter is
>solely cultural.
>
>Tapash Bedajna
>
>Allen Worrall <jworrall@alaska.net> wrote:
>Interesting question and area of investigation. I guess if Asian women
>are generally a little smaller in stature than US women, it would be
>reasonable to assume that Asian women has slightly smaller vaginas. I
>have practiced obstetrics and gynecology for 55 years and do not think
>there is any significant difference in the size or capacity of the
>female vagina between various ethnic groups.
>
>Of course it makes a huge difference if the woman has had vaginal
>births or not. Also the woman's state of mind at the time of the exam
>will make a huge difference in terms of the "fit" of the transducer into
>her vagina.
>
>I have noticed that in India and Pakistan, if a woman is unmarried, it
>is assumed that she is a virgin and that transvaginal ultrasound is not
>possible or desirable. I think I understand at least some of the reasons
>for this.
>
>In the US we tend to assume that transvaginal ultrasound is possible in
>any adult woman regardless of her marital state. And I would say that
>most of the time we are correct. I would guess that virginity in the US
>is not prized or considered necessary (or even desirable) by many young
>women, whereas in India and Pakistan the opposite is true.
>
>I have never practiced in India or Pakistan, but I would guess that
>transvaginal ultrasound is better accepted by US women than Indian or
>Pakistani women, because of the cultural differences. This better
>acceptance is probably the main reason that you noted different data
>from US and European sources compared to Asian sources.
>
>I hope that some of our colleagues in India and Pakistan will comment
>on this.
>
>Allen
>
>Joseph A Worrall MD RDMS
>OB/GYN Ultrasound at the Fairbanks Clinic
>Fairbanks, AK 99701
>
>out!
>
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--
art fougner, md
"If you don't know where you are going, you will wind up somewhere else."
Lawrence Peter Berra
