Ultrasonography

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In the last decades, the use of Ultrasonography has become increasingly common in medical practice and hospitals around the world, and the superiority of ultrasonography over commonly used X-ray techniques has resulted in significant changes in diagnostic imaging procedures. 

At Palmars Hospital, ultrasound is a core technology for diagnostics and remains one of the safest.  With a responsible and cautious approach to ultrasound, patient safety is assured and clinical effectiveness is enhanced. We use the lowest exposure necessary to provide essential diagnostic information.

Our clinical use of ultrasound covers obstetrics scanning (Doppler ultrasound in pregnancy), gynecological ultrasonography (abdomino-pelvic scanning), paediatric ultrasound, cardiac ultrasound, thoracic ultrasound, and visualization of small structures in the musculo-skeletal system.

Gynaecology (Uterus and ovaries)

Gynaecological Ultrasonography is a non-invasive imaging technique that can be used:

 ■ in the diagnostic work-up of pelvic masses suspected on the basis of history and pelvic clinical examination;

 ■ in the diagnostic work-up of dysfunctional or infective diseases that involve or can involve the pelvis; 

■ in the differential diagnosis of other acute abdominopelvic diseases (appendicitis, diverticulitis, inammatory bowel diseases); 

■ in the peri- and postmenopausal diagnostic evaluation of women with atypical uterine bleeding, in order to dene the macroscopic characteristics of the endometrium and uterine cavity; 

■ in ovarian and endometrial surveillance of women at high-risk for ovarian and endometrial cancer (familial, drugs); 

■ in monitoring spontaneous or drug-induced ovulation; 

■ in monitoring therapy and surgery.

Obstetrics

First trimester trimester is the gestational period between conception and 13 weeks + 6 days of gestational age. An embryo is the product of conception until 10 weeks + 0 days of gestational age; a fetus is the product of conception from 10 weeks + 1 day until delivery.

Indications for ultrasound during the first trimester are: 

■ vaginal bleeding or pelvic pain;

 ■ a discrepant uterine size for gestational age;

 ■ estimation of gestational age; 

■ support for an invasive diagnostic procedure (e.g. sampling the chorionic villus);

■ prediction of the risk for recurrence of fetal anomalies; 

■ screening for fetal anomalies and aneuploidies (in selected, high-risk pregnancies); 

■ routine assessment (screening) of low-risk pregnancies. 

Purposes of ultrasound during the first trimester are: 

■ to visualize the gestational sac inside the uterus and evaluate the number and implant site of sacs;

 ■ to visualize the embryo or fetus, evaluate their number and visualize their cardiac activity;

 ■ to estimate gestational age, by measuring the mean sac diameter or crown– rump length or the biparietal diameter of the head; 

■ to evaluate the morphology of the uterus and adnexa; 

■ to provide an early diagnosis of fetal anomalies (in selected cases);

 ■ to screen for aneuploidy (in selected cases).

With these evaluations, it is possible to diagnose during the first trimester: 

■ a normal (intrauterine) or ectopic (intra- or extrauterine) implant; 

■ embryo or fetus life or early pregnancy failure (miscarriage, abortion)

■ the number of embryos or fetuses (single or multiple pregnancy);

 ■ chorionicity and amnionicity in multiple pregnancies; 

■ correct gestational age; 

■ anomalies of the uterus (e.g. malformations, myomas) and adnexa (e.g. cysts, neoplasms); 

■ morphological fetal abnormalities; 

■ aneuploidy, by measuring nuchal translucency between 11 and 14 weeks of gestation.

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