Re: Endovaginal in 1st trimester

From: art fougner, md (evsono@pipeline.com)
Fri Mar 6 06:53:44 1998


more $0.02 most of our 1st TM work include vaginal views - some exclusively. i know i am preaching to the choir here but you utilize the approach that yields the information. interestingly, Nicolaides demonstrated that most of his info re: nuchal trans could be obtained quite satisfactorily by the abdominal approach. additionally, as luck would have it, the last two ectopics here could be best demonstrated with the abdominal approach. with regard to the question of anomaly detection such as Ashley's case, we look vaginally at about 12-13 wks in cases with increased risk and have picked up a recurrent Meckel-Gruber syndrome at 12 wks.

art

At Fri, 06 Mar 1998, James S Smeltzer MD wrote: >
>At 08:22 PM 3/4/1998 -0600, you wrote:
>>I do hope full bladder views are done first. Many times the endovaginal
>>only views do not adequately penetrate above the uterine fundus and high
>>ovarian masses as well as pedunculated fibroids are missed too often.
>
>Good point. I've seen ovarian tumor (14 cm) missed & a fibroid that
>reached the xiphoid. TVS alone is not adequate, but the detection of early
>nuchal lucency & other severe defects early in pregnancy are still good
>reasons to perform TVS.
>
>Moral of the story: Its hard to see the tree when your nose is in the bark!

--
art fougner, md
SonoScan/Genetic Sciences
forest hills, ny
evsono@pipeline.com



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