Method for the diagnosis of delayed fetal development
(57) Abstract:The method can be used in medicine, namely in obstetrics. Spend Doppler mapping and determine the nature of blood flow in the radial and spiral uteroplacental arteries. With increasing indexes pulsations in these arteries compared with the same data in healthy pregnant patient is referred to the risk of delayed development of the fetus in the later stages of pregnancy. The method improves the accuracy of diagnosis. The invention relates to medicine, namely to obstetrics.Diagnosis of complications of pregnancy in the first trimester (threatened miscarriage, frozen pregnancy and other) based on the complaints of the patient, data inspection gynecologist and ultrasound examination of the pelvic organs.It is established that the pathology of the second and third trimesters (placental insufficiency, fetal development, fetal hypoxia, and others ) is often a result of violation of uteroplacental blood flow in the early stages of gestation .The accuracy of the diagnosis of complicated pregnancy, resulting in stunting of locationone allows you to visualize the blood flow in the vessels and to estimate its parameters: direction, the speed and nature . However, the known methods do not allow sufficient accuracy to predict the fetal development in the second and third trimesters of pregnancy.The basis of the invention is the task of forecasting complicated pregnancy on early terms for definition of tactics of treatment of the patient, the choice of the most rational therapy aimed at correcting violations.The invention consists in that in the method for the diagnosis of delayed development of the fetus by ultrasound of the uterus, including Doppler mapping of the vessels of the uterus and determining the status of their blood supply on the basis of the index ripple additionally spend Doppler mapping and determination of the nature of blood flow in the radial and spiral uteroplacental arteries and with increasing indexes pulsations in these arteries compared with the same data in healthy pregnant patient is referred to the risk of delayed development of the fetus in the later stages of pregnancy.As a result, the method allows to predict the fetal development, placental insufficiency in the second Tr is the first study of the pregnant uterus in the early stages of gestation perform color Doppler mapping of the vessels of the uterus (uterine arteries, the right and left). Then determine the index of pulsation in the radial and spiral arteries. When pronounced asymmetry of blood flow in the right and left uterine arteries, the increase of indexes of pulsation in the radial and spiral arteries, the patient is at risk of delayed development of the fetus at a later time. Thus, the decrease in the pulsation in the radial and spiral arteries in early pregnancy serves as a prognostic sign of the occurrence of delayed fetal development.The data obtained indicate that the performance of the index ripple in complicated pregnancy (the threat of termination, the combination of pregnancy with extragenital pathology and others) statistically significant change in uterine, radial and spiral arteries. With further prolongation of pregnancy in the group impaired uteroplacental blood flow, often develop complications such as fetal development and placental insufficiency.Example 1.The patient Arkhangelsk, P., 31, was admitted to the gynecological Department CCH 29 with complaints about the poor bloody discharge from the genital tract. After holding on the ANOVA pelvis. Diagnosed with uterine pregnancy for a period of 10 weeks. The research on uteroplacental blood flow using color Doppler mapping. In the mother, radial and spiral arteries performance indexes surge exceeded (index ripple >1,8) the average value for a given period of gestation, which allowed us to classify the patient at increased risk for the development of pregnancy complications. After the treatment, aimed at preserving the pregnancy, the patient was discharged from the hospital with progressive pregnancy. During the pregnancy she was held ULTRASOUND study with compulsory pyometria and Doppler flow study. During the period of 27 weeks by ultrasound found stunted fetus at 2 weeks compared with the gestational period. Was exhibited: the diagnosis of fetal development 1 degree, in connection with which a pregnant woman was hospitalized in the Department of pathology of pregnancy, maternity place of residence, where he received appropriate treatment of this pathology.Example 2.The patient Morozova O. Century, 30 years, was admitted to the gynecological Department CCH 29 complaints dragging pain in the lower abdomen. religious site 9.5 cm). According to doplerometry index ripple in the uterine arteries was 2,35 in the right and 2,71 on the left. Index values of pulsation in the radial and spiral arteries also exceeded (>1) the average values of the same indices in comparison with the same indicators in women with uncomplicated pregnancy. After the treatment, aimed at preserving the pregnancy, written under the supervision of a doctor of female consultation. Rodorazresheniye in the period 35-36 weeks by caesarean section on wire placental insufficiency, the initial signs of hypoxia.Sources of information
1. Saveliev, M., Fedorova, M. C., Klimenko, P. A., L. Sichinava, Placental insufficiency. - M.: Medicine. - 1991, S. 6-7.2. Sidelnikov Century Meters Miscarriage. - M.: Medicine. - 1986. S. 70-71.3. Jaffe R., Wassot S. L. Color Doppler imaging in the assessment of uteroplacental blood flow in abnormal trimester intrauterine pregnancies. An attempt to define etiologic mechanism. //J. Ultrasonudmed. - 1992. - vol. 11(1). - p. 41-44. Method for the diagnosis of delayed development of the fetus by ultrasound examination of the uterus, including Doppler mapping of the vessels of the uterus and determining the status of their blood supply on the basis of the index ripple, characterized in that the material uteroplacental arteries and with increasing indexes pulsations in these arteries compared with the same data in healthy pregnant patient is referred to the risk of delayed development of the fetus in the later stages of pregnancy.
SUBSTANCE: method involves examining eyeball and retrobulbary space by means of ultrasonic scanner. Ultrasonic gray scale orbit scanning is applied in real-time mode to determine ultrasonic eye reposition. Positive ultrasonic eye reposition is determined and normal state is diagnosed when recording mobile unchanged shape and free oscillation orbit tissue movements. Changes in shape, contours and size of the eyeball and immobility of orbit tissues being recorded, negative ultrasonic reposition is determined and solid full-tissue neoplasms and structures are diagnosed to occur.
EFFECT: high objectivity of received data; accelerated examination; high accuracy of differential diagnosis.
SUBSTANCE: method involves applying polypositional ultrasonic scanning techniques in real time mode. Echo pattern of thinned fibrous ring to 1 mm or its rupture or anteroposterior vertebral canal size reduction by more than 4 mm, vacuum phenomenon, nerve radix compression with asymmetry more than 2 mm is to be recognized.
EFFECT: high accuracy of non-invasive, non-ionizing primary diagnosis method.
FIELD: medicine, surgery.
SUBSTANCE: one should carry out virological testing patient's blood serum and hepatic bioptates. At detecting TTVDNA and HGVRNA it is necessary to perform ultrasound survey, and at availability of biliary sludge one should conclude upon early stage of cholelithiasis.
EFFECT: higher accuracy of diagnostics.
SUBSTANCE: method involves measuring uniform ampoule-like enlargement area of nerve trunk smoothly transforming itself into hypoechogenic formation with smooth distinct outline of no longitudinal striation echo-structure in longitudinal projection and enlarged rounded hypoechogenic region with changed echo-structure without granularity in transverse projection observed in visualizing the nerve trunk enlargement in transverse scanning mode. Area of zone proximally located 3-4 cm far from lesion region. Asymmetry coefficient is determined as ratio of the values. The coefficient value being greater than 2.4, terminal neuroma is diagnosed witnessing complete nerve rupture. When visualizing the single side nerve boundary enlargement in both projections with hypoechogenic zone of disturbed echogenicity structure and retained nerve segment unchanged at this level under asymmetry coefficient value being less than 2.4, lateral neuroma is diagnosed to be the case witnessing partial nerve rupture. When finding zone of linear striation echo-structure in longitudinal scanning mode and showing echo-structure granularity in transverse scanning mode not greater than 1.7 times proximal zone area 2-6 months later after the operation, fascicle nerve structure recovery in suture vicinity is considered to take place. Ampoule-like enlarged, hypoechogenic formation having partially disturbed inhomogeneous heterogeneous structure 1.7 times greater than proximal zone area being found within this period, intensive nerve trunk connective tissue elements proliferation and intratrunk neuroma is proved to be the case.
EFFECT: high accuracy in determining nerve injury degree; enhanced effectiveness in controlling postoperative nerve fiber recovery.
2 cl, 3 dwg
SUBSTANCE: one should perform ultrasound testing cholecystic bile and at detecting hyperechogenic particles and decreased contractile function of cholecystic wall by 25% and more one should diagnose early stage of cholelithiasis.
EFFECT: higher accuracy of early diagnostics.
3 ex, 6 tbl
FIELD: medicine, urological ultrasound diagnostics.
SUBSTANCE: ureterectasia should be developed below prepyeloureteral department, one should cause functional obstruction in ureterovesical segment: a patients should fill urinary bladder to achieve high values of pressure in it, restrict urinary passage through ureterovesical anastomosis, perform medicinal polyuria due to intravenously introduced lasix at age dosage at simultaneous introduction of an analgesic. About 10 min after lasix introduction one should perform ultrasound testing in the course of which an increased upper third of patient's ureter enables to localize pyeloureteral segment, detect the length of obstruction and due to Doppler scanning detect either availability or absence of inferior polar vessel. The method enables to determine indications to apply open surgical techniques of hydronephrosis and endoscopic methods (endopyelotomy).
EFFECT: higher efficiency of ultrasound diagnostics.
5 dwg, 3 ex
SUBSTANCE: method involves carrying out differential diagnosis study for determining prostate tumor type. Transrectal ultrasonic examination is carried out and prostate-specific antigen density is determined in patient blood serum. Free fraction density of the prostate-specific antigen being below 0.04 ng/ml per 1 cm3, and general prostate-specific antigen concentration being equal to 0-20 ng/ml, malignant tumor is to be diagnosed. General prostate-specific antigen concentration being higher than 20 ng/ml, malignant tumor is to be diagnosed.
EFFECT: high diagnosis accuracy.
SUBSTANCE: method involves determining transformed abdominal wall region by means of ultrasound. The sclerosis focus being detected, rheopolyglukine solution is introduced into space between direct muscle belly and its posterior sheath plate before applying repeated ultrasonic examination.
EFFECT: high accuracy in measuring area occupied by structural elements and determining transformed tissue region boundary; objective muscle fiber atrophy and cicatricial sclerosis development degree estimation.
SUBSTANCE: method involves recording middle uterus echo and endometrium volume. Uterus body volume is additionally determined and endometrium volume to uterus body volume ratio index (EV/UV) is calculated. The index values within 5 to 10% are thought to be norm for reproductive age women. The EV/UV value being between 10 and 19%, the women are thought to belong to risk group and ultrasonic control is advised for being carried out within 1 year. The value being between 19 and 40%, it is advised to the female patients to pass through diagnostic endometrectomy procedure and carry out histological examination. The value being greater than 40%, the women are sent to be treated in oncological clinical centers. The EV/UV value between 3 and 7% is considered to be norm for female patients within their 5 years long postmenopausal period. The value being between 7 to 13%, the women are included into risk group and ultrasonic control is to be carried out within six months. The value being between 13 to 35% corresponding to endometrium hyperplasia, it is advised to the female patient group to pass through diagnostic endometrectomy procedure and then to carry out histological examination. The value being greater than 35%, treatment in an oncological clinical center is recommended.
EFFECT: high reliability and accuracy of diagnosis.
2 dwg, 3 tbl
SUBSTANCE: method involves carrying out ultrasonic examination of neck region. The ultrasonic examination is carried out by alternating scanning in frontal and frontolateral planes using superficial; transducers tuned at wavelengths of 5.0 MHz and 7.5 MHz in varying inclination angle from 45° to 135° from mental region downward along trachea to upper poles and thyroid gland isthmus level. Zones having echogenic parameters differing from those of normal tissues, tumor neoplasm availability is diagnosed.
EFFECT: high accuracy in visually determining laryngeal bulk neoplasms.