Evaluation of obstetric ultrasonography at the first prenatal visit

Article Abstract:

Although an ultrasonographic examination is often performed during a pregnant woman's first prenatal visit to a physician, the value of such an examination has not been systematically evaluated. In this prospective study, 1,000 pregnant women underwent a physical examination and obstetric ultrasonography on their first prenatal visit. Uterine size was measured in various ways, depending on the gestational age of the pregnancy. Seven hundred thirty-seven patients were in the first trimester of pregnancy; 200 in the second trimester; and 63 in the third trimester. Abnormalities were found on ultrasonographic examination in 36.5 percent of the cases. A discrepancy between the dating of the pregnancy by menstrual history and ultrasonography was found in 26.8 percent of the cases. In 59 percent of these cases, the correct dating would not have been established by physical examination. Missed abortion (fetal death prior to 20 weeks gestation in which the products of conception are retained for eight or more weeks) was found in 7.6 percent of the first trimester patients, 41 percent of whom had no bleeding. Twins were diagnosed in six cases. Forty-seven percent (365 women) of the clinically relevant abnormalities were suspected from clinical examination. Thus, more abnormalities were found with ultrasonography than with clinical examination and laboratory tests. Physical examination was not accurate in dating the pregnancies. The cost and time associated with ultrasonography in the first prenatal visit are discussed. In the authors' practice, it usually requires fewer than 10 minutes and is performed without additional charge as part of the first visit. Its routine use during this visit is recommended for all patients. (Consumer Summary produced by Reliance Medical Information, Inc.)

Methods, Evaluation, Prenatal diagnosis, Prenatal ultrasonography, Ultrasonics in obstetrics

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Stage I corpus cancer: is teletherapy necessary?

Article Abstract:

Surgical removal of the uterus and lymph nodes may prevent recurrence of uterine cancer without the need for radiation therapy. Researchers evaluated the outcomes of 396 endometrial cancer patients who underwent extensive surgical staging and removal of the uterus and lymph nodes. Surgical complication rates were not excessive. Almost all (97%) patients with stage I disease survived for at least five years after surgery. Radiation therapy after surgery may not be necessary when thorough tumor staging is performed even for patients with stage IB and IC cancer and may not reduce survival rates.

Surgery, Cancer, Endometrial cancer, Tumor staging, Cancer staging, Cancer recurrence

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