Diagnostic ultrasound ( PDFDrive )

1084 PART IV Obstetric and Fetal Sonography
with single-agent therapy. High-risk, poor-prognosis disease is
indicated by duration of disease for more than 4 months, pretreatment
hCG levels greater than 40,000 mIU/mL, presence of brain
or liver metastases, antecedent term pregnancy, and prior history
of failed chemotherapy. hese patients are treated aggressively
with appropriate combinations of intense multiagent chemotherapy,
adjuvant radiotherapy, and surgery. By tailoring therapy
in this way, even high-risk patients have cure rates of 80% to
90%. 151,159
CONCLUSION
First-trimester sonography plays an important role in establishing
the location of a pregnancy and determining if the pregnancy
is potentially viable (cardiac activity seen). Knowledge of the
landmarks with respect to the appearance of the gestational sac,
yolk sac, and embryo are important in the appropriate triage of
patients who present with pain and bleeding in the irst
trimester.
REFERENCES
1. Moore KL. he developing human: clinically oriented embryology. 10th
ed. Philadelphia: Elsevier; 2016.
2. Levi CS, Lyons EA, Lindsay DJ. Early diagnosis of nonviable pregnancy
with endovaginal US. Radiology. 1988;167(2):383-385.
3. Levi CS, Lyons EA, Zheng XH, et al. Endovaginal US: demonstration of
cardiac activity in embryos of less than 5.0 mm in crown-rump length.
Radiology. 1990;176(1):71-74.
4. Abdallah Y, Daemen A, Kirk E, et al. Limitations of current deinitions of
miscarriage using mean gestational sac diameter and crown-rump length
measurements: a multicenter observational study. Ultrasound Obstet Gynecol.
2011;38(5):497-502.
5. Doubilet PM, Benson CB, Bourne T, et al. Diagnostic criteria for nonviable
pregnancy early in the irst trimester. N Engl J Med. 2013;369(15):
1443-1451.
6. Nyberg DA, Filly RA. Predicting pregnancy failure in ‘empty’ gestational
sacs. Ultrasound Obstet Gynecol. 2003;21(1):9-12.
7. Levi CS. Prediction of early pregnancy failure on the basis of mean gestational
sac size and absence of a sonographically demonstrable yolk sac. Radiology.
1995;195(3):873.
8. Rowling SE, Langer JE, Coleman BG, et al. Sonography during early
pregnancy: dependence of threshold and discriminatory values on transvaginal
transducer frequency. AJR Am J Roentgenol. 1999;172(4):
983-988.
9. Benacerraf BR, Shipp TD, Bromley B. Does the 10-MHz transvaginal
transducer improve the diagnostic certainty that an intrauterine luid
collection is a true gestational sac? J Clin Ultrasound. 1999;27(7):
374-377.
10. Moore KL, Persaud TVN, editors. he developing human: clinically oriented
embryology. 6th ed. Philadelphia: Saunders; 1998.
11. Oehninger S, Hodgen GD. Hypothalamic-pituitary-ovarian uterine axis.
In: Copeland LJ, editor. Textbook of gynecology. Philadelphia: Saunders;
1993.
12. Jones GS, Jones HW. Cyclical cytology and histology. In: Jones GS, Jones
HW, editors. Gynecology. 3rd ed. Baltimore: Williams & Wilkins; 1982. p.
46-68.
13. Settlage DS, Motoshima M, Tredway DR. Sperm transport from the external
cervical os to the fallopian tubes in women: a time and quantitation study.
Fertil Steril. 1973;24(9):655-661.
14. Suarez SS, Pacey AA. Sperm transport in the female reproductive tract.
Hum Reprod Update. 2006;12(1):23-37.
15. Lyons EA, Taylor PJ, Zheng XH, et al. Characterization of subendometrial
myometrial contractions throughout the menstrual cycle in normal fertile
women. Fertil Steril. 1991;55(4):771-774.
16. Hustin J. Vascular physiology and pathophysiology of early pregnancy. In:
Bourne T, Jauniaux E, Jurkovic D, editors. Transvaginal color Doppler.
Heidelberg: Springer-Verlag; 1995. p. 47-56.
17. Jauniaux E. Intervillous circulation in the irst trimester: the phantom of
the color Doppler obstetric opera. Ultrasound Obstet Gynecol. 1996;8(2):
73-76.
18. Hustin J, Jauniaux E, Schaaps JP. Histological study of the materno-embryonic
interface in spontaneous abortion. Placenta. 1990;11(6):477-486.
19. Oh JS, Wright G, Coulam CB. Gestational sac diameter in very early
pregnancy as a predictor of fetal outcome. Ultrasound Obstet Gynecol.
2002;20(3):267-269.
20. Folkman J. Tumor angiogenesis: therapeutic implications. N Engl J Med.
1971;285(21):1182-1186.
21. Kawakami Y, Andoh K, Mizunuma H, et al. Assessment of the implantation
site by transvaginal ultrasonography. Fertil Steril. 1993;59(5):1003-1006.
22. Magann EF, Roberts WE, McCurley S, et al. Dominant maternal sleep
position inluences site of placental implantation. Mil Med. 2002;167(1):
67-69.
23. Yeh HC, Goodman JD, Carr L, Rabinowitz JG. Intradecidual sign: a US
criterion of early intrauterine pregnancy. Radiology. 1986;161(2):
463-467.
24. Chiang G, Levine D, Swire M, et al. he intradecidual sign: is it reliable for
diagnosis of early intrauterine pregnancy? AJR Am J Roentgenol. 2004;
183(3):725-731.
25. Bradley WG, Fiske CE, Filly RA. he double sac sign of early intrauterine
pregnancy: use in exclusion of ectopic pregnancy. Radiology. 1982;143(1):
223-226.
26. Nyberg DA, Laing FC, Filly RA, et al. Ultrasonographic diferentiation of
the gestational sac of early intrauterine pregnancy from the pseudogestational
sac of ectopic pregnancy. Radiology. 1983;146(3):755-759.
27. Doubilet PM, Benson CB. First, do no harm… To early pregnancies.
J Ultrasound Med. 2010;29(5):685-689.
28. Nyberg DA, Mack LA, Harvey D, Wang K. Value of the yolk sac in evaluating
early pregnancies. J Ultrasound Med. 1988;7(3):129-135.
29. Parvey HR, Dubinsky TJ, Johnston DA, Maklad NF. he chorionic rim and
low-impedance intrauterine arterial low in the diagnosis of early intrauterine
pregnancy: evaluation of eicacy. AJR Am J Roentgenol. 1996;167(6):
1479-1485.
30. Doubilet PM, Benson CB. Double sac sign and intradecidual sign in early
pregnancy: interobserver reliability and frequency of occurrence. J Ultrasound
Med. 2013;32(7):1207-1214.
31. Birnholz JC, Madanes AE. Amniotic luid accumulation in the irst trimester.
J Ultrasound Med. 1995;14(8):597-602.
32. Campbell J, Wathen N, Macintosh M, et al. Biochemical composition of
amniotic luid and extraembryonic coelomic luid in the irst trimester of
pregnancy. Br J Obstet Gynaecol. 1992;99(7):563-565.
33. Emerson DS, Cartier MS, Altieri LA, et al. Diagnostic eicacy of endovaginal
color Doppler low imaging in an ectopic pregnancy screening program.
Radiology. 1992;183(2):413-420.
34. Laing FC, Brown DL, Price JF. Intradecidual sign: is it efective in diagnosis
of an early intrauterine pregnancy? Radiology. 1997;204(3):655-660.
35. Golstein DP, Koaca TS. he subunit radioimmunoassay for hCG: clinical
application. In: Taymar M, Green TH, editors. Progress in gynecology. New
York: Grune & Stratton; 1975. p. 145-184.
36. Nyberg DA, Filly RA, Filho DL, et al. Abnormal pregnancy: early diagnosis
by US and serum chorionic gonadotropin levels. Radiology. 1986;158(2):
393-396.
37. Stenman UH, Tiitinen A, Althan H, Valmu L. he classiication, functions,
and clinical use of diferent isoforms of HCG. Hum Reprod Update.
2006;12(6):769-784.
38. Connolly A, Ryan DH, Stuebe AM, Wolfe HM. Reevaluation of discriminatory
and threshold levels of serum β-hCG in early pregnancy. Obstet Gynecol.
2013;121(1):65-70.
39. Barnhart K, Mennuti MT, Benjamin I, et al. Prompt diagnosis of ectopic
pregnancy in an emergency department setting. Obstet Gynecol. 1994;84(6):
1010-1015.
40. Bree RL, Edwards M, Bohm-Velez M, et al. Transvaginal sonography in
the evaluation of normal early pregnancy: correlation with HCG level. AJR
Am J Roentgenol. 1989;153(1):75-79.