Diagnostic imaging in puerperal febrile morbidity

Article Abstract:

Puerperal febrile morbidity is fever affecting the mother for two days between the 2nd and 10th day after childbirth. It occurs in 2 to 3 percent of vaginal deliveries and 25 to 95 percent of cesarean deliveries, results from a number of problems, and usually responds to antibiotic therapy. This study examined using imaging techniques to diagnose and determine treatment for women with puerperal fever morbidity. The techniques studied were ultrasound, computed tomography (CT, which uses computer generated X-ray images), and magnetic resonance imaging (MRI, which uses the magnetic properties of elements to produce images). Clinical and diagnostic imaging data were assessed for 31 women who suffered puerperal febrile morbidity that did not respond to at least 72 hours of antibiotic treatment. These patients were among 7,749 women who gave birth during the study period at one Philadelphia hospital. Of these 31 women, 35 percent were between the ages of 14 and 19; this age group represented only 14.5 percent of all deliveries. Cesarean deliveries were performed for 74 percent of the 31 women, compared with an 18.4 percent cesarean rate for all the mothers. Fourteen of the 31 mothers (45 percent) had blood transfusions during pregnancy because of hemorrhage. Imaging results were the primary means of diagnosing and deciding how to treat the mothers. Hematomas, or masses of clotted blood, were found in various tissues and organs in 11 of the 31 patients using one or more of the imaging techniques. Abscesses occurred in seven women and were detected by imaging in six of them. Endomyometritis, inflammation of the mucous membrane and muscles of the uterine wall, was diagnosed in 21 mothers. Imaging findings showed signs of this problem in 11 patients and other abnormalities outside the uterine wall in 13. These results demonstrate that diagnostic imaging is useful in determining both the cause and treatment for women with puerperal febrile morbidity that does not respond to antibiotic therapy. (Consumer Summary produced by Reliance Medical Information, Inc.)

Usage, Complications and side effects, Childbirth, Delivery (Childbirth), Diagnostic imaging, Puerperal fever, Puerperal infection

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Ultrasound examination for detection of ovarian carcinoma in risk groups

Article Abstract:

Ovarian carcinoma (cancer) has usually reached an advanced stage when it is detected, and, as a result, mortality associated with this disease is high. Screening tests that allow definitive, early diagnosis have not been developed. To determine whether ultrasound examination would be useful in diagnosing ovarian cancer among high-risk women, a study of 801 high-risk gynecologic patients in Sweden was carried out. Patients were considered high-risk if they: were older; had borne no children; had a previous history of any cancer, or a family history of breast, ovarian, or endometrial (uterine lining) cancer; or had a history of abdominal symptoms with no apparent cause. The women underwent manual gynecologic examination, followed by ultrasonographic scanning. Results from ultrasound were compared with those from pelvic examination, surgery, and histological analysis. Normal ultrasound results were obtained for 638 women; pelvic examination was abnormal for 51. None of these 51 patients developed ovarian cancer by the time the study ended (6 to 37 months after examination). Ovarian cancer was not detected in the remaining women, whose scans and pelvic examinations were normal. Abnormal scans and normal pelvic examination results were obtained for 108 women; surgery was performed in 30 cases. Three malignancies were detected (one borderline ovarian tumor, two endometrial carcinomas), and repeat scans were either normal or malignancy was ruled out for the remainder. Findings were abnormal for both examinations in 55 patients; of this group, 6 malignancies were detected. The rate of ovarian cancer in the Swedish population is low (40 to 130 cases per 100,000 women). These results indicate that ultrasound screening, even among high-risk women, is not a valuable screening tool for ovarian cancer in this population. (Consumer Summary produced by Reliance Medical Information, Inc.)

Sweden, Ovarian cancer

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Ovarian vein thrombosis with atypical presentation: role of sonography and duplex Doppler

Article Abstract:

Blood clots (thromboses) were detected in ovarian veins by using sound waves to record an image (sonography) and duplex Doppler, which measures the rate of blood flow, in two patients. One developed the blood clot after surgery, and the other after giving birth. Both patients experienced mild, atypical symptoms. The condition was diagnosed by using the Doppler technique, which demonstrated the presence of the blood clot in the ovarian vein by detecting that no blood was flowing past the clot. Patients at risk for blood clots, with typical or atypical symptoms, should be initially examined using both sonography and the duplex Doppler.

Ultrasound imaging, Ovaries, Thrombosis, Doppler ultrasonography, Blood circulation disorders, Vascular diseases

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