PMID 8259385 8259385 DOI 10.1148/radiology.190.1.8259385 10.1148/radiology.190.1.8259385
Cite this article
Thurmond, A. S. (1994). Pregnancies after selective salpingography and tubal recanalization. Radiology, 190(1), 11-13. https://doi.org/10.1148/radiology.190.1.8259385
Thurmond AS. Pregnancies after selective salpingography and tubal recanalization. Radiology. 1994;190(1):11-13. doi:10.1148/radiology.190.1.8259385
Thurmond, A. S. "Pregnancies after selective salpingography and tubal recanalization." Radiology, vol. 190, no. 1, 1994, pp. 11-13.
To test a sonoscopic technique developed for transvaginal catheterization and recanalization of the fallopian tube. In a feasibility study, catheterization was performed with the use of laparoscopic control. Patients with bilateral proximal tubal obstruction underwent fallopian tube recanalization under ultrasonic observation. This study represents patients evaluated for primary or secondary infertility at Humboldt University Hospital. PATIENTS, Proximal tubal obstruction had been diagnosed on previous hysterosalpingogram and with laparoscopy. None. Tubal patency was assessed by hydrotubation under ultrasonic observation. Transvaginal catheterization was successful in 31 (91.2%) of the 34 tubes. In 19 patients with proximal tubal obstruction, patency of both or at least one tube was achieved in 16 (84.2%) women. Five (31.6%) of 16 patients successfully recanalized were found to have an intrauterine pregnancy at a 6-month follow-up interval. This catheterization technique should be investigated for possible use in diagnostic schedule early in the evaluation of the infertile patient. Also, the transvaginal recanalization of proximally obstructed tubes calls into question the application of microsurgical treatment of a selected group of patients.
Bone HealthBone Density MeasurementOsteoporosis PreventionBone Densitometry
Osteoporosis has lately become recognized as an important disease on two accounts. On one hand, demographic change has resulted in a greatly increased and increasing burden of morbidity and mortality due to osteoporotic fracturing. On the other hand, lifestyle changes and preventive measures have become recognized as important factors in prevention of both osteoporosis and osteoporotic fractures, while several effective drug treatments have recently become available to treat osteoporosis by increasing bone density and reducing fracture incidence. Because bone density is, with age, the best predictor of fracture risk, its measurement has become central to the care of those potentially at risk. When a clinician refers a person for a bone density examination, the clinician should be concerned less with an "imaging diagnosis" than with the requirement that the laboratory has procedures in place for rigorous quality assurance and precision measurements, as well as for education of the staff involved. Implementation of these measures and an understanding of their clinical relevance in diagnosis and follow-up, as well as communication with clinicians in this context, are more important than any diagnostic insight that might be provided by "interpreting" a bone density study.
Transcervical fallopian tube catheterization (TFTC) was performed in 22 infertile patients with bilateral fallopian tube obstruction and a mean duration of infertility of 3.3 years. A high prevalence of previous ectopic pregnancy (n = 8, 36%), tubal ligation and/or reconstruction (n = 5, 23%), spontaneous or therapeutic abortion (n = 6, 27%), and previous intrauterine device use (n = 14, 64%) was noted. The authors successfully catheterized 40 (98%) of 41 tubes without serious complication and visualized the distal tube in 36 (88%) of 41 tubes. Free spill in at least one tube was seen in 17 (77%) of 22 patients. Nineteen patients had a history of previous laparoscopy or laparotomy for tubal disease, in 16 of whom laparoscopic results were available for review. Retrospectively, in 15 (94%) of 16 patients all clinically relevant abnormalities would have been detected by means of TFTC alone. Five patients conceived, three with intrauterine and two with ectopic pregnancies. Patients with intrauterine pregnancies had normal-appearing tubes after TFTC, while those with ectopic pregnancies had residual tubal abnormalities after recanalization. TFTC is a safe, accurate diagnostic procedure that provides more information than hysterosalpingography and, in most cases, as much or more information about the fallopian tubes than laparoscopy.
General OB/GYNObstetrical UltrasoundBladder Artifact EffectsPlacenta Previa Diagnosis
Observations of random obstetrical cases out of a large-volume practice are presented to demonstrate the often overlooked effects of filling the urinary bladder for obstetrical sonography. The effects, predominantly evident in the second trimester, perssure effects on the lower uterine segment, displacement of the cervix and/or corpus of the uterus, rotation, flexion, version, and tilting of the uterus. These events may affect the perception of placenta location and fetal position. This is especially important in the diagnosis of placenta previa in the second trimester. Many instances of placental "migration" may be due to this phenomenon. Implications for amniocentesis are briefly discussed.