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Re: Endovaginal in 1st trimesterFrom: James S Smeltzer MD (gaperina@mindspring.com)Mon Mar 9 10:53:51 1998
At 10:24 PM 3/6/1998 -0600, you wrote: >>LOL! >Right, you are! But you can't steal it, it is already out there. >TJDuB >-- >On Fri, 6 Mar 1998 22:10:47 -0600 DRoss38040 <DRoss38040@aol.com> writes: >>In a message dated 98-03-06 04:20:49 EST, gaperina@mindspring.com >>writes: >> >><< Moral of the story: Its hard to see the tree when your nose is in >>the bark! >>>> >> >>LOL! >> >>I love this one! ....it is the classic answer to this question. I'm >>going to steal it! >> >>Diana Ross, RT, RDMS > Thank you - on the other hand what species of tree is best determined by the bark. Since I've been doing TAS & TVS since 1985, neither has ALWAYS been the whole truth. TVS is clearly better for ectopic pregnancy (including abdominal - where does the cervix go?), characterization of vascular flow, early pregnancy evaluation, endometrial dating & pathology, details of ovarian & tubal pathology. TAS will not miss a large abdominal or abd - pelvic mass or large fundal fibroid as often. On balance, in a busy setting, I've been a firm singer of the benefits of TVS since inception - a better window is a better window. Also using the TV probe for fetal ICA & through the umbilicus for fetal echoes & special anatomic views. The reaction of my partners & the sonographers when I started using the phased array 5MHz sector of the GE RT3000 as a TV probe was amusing: "He put it where?" The sonographers came around much faster because they could SEE so much better. Reading studies, they are more easily determined to be "adequate" by TAS, if less informative. If US is an adjunct to the pelvic examination, TVS is much more frequently helpful in providing additional information, but this also has its problems. Screening studies of PMP ovaries have shown a high frequency of asymptomatic adnexal "pathology" that is often not pathological and is 33 to 1 against ovarian Ca - odds improved by doppler.
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