Keywords : transvaginal ultrasound


Comparism Between Transvaginal Cervical Length Measurement and Digital Examination in Prediction of Imminent preterm Delivery

Maha M. AL-Bayati; Asmaa Mohammed Abid; Shaima Kadhim Jasim

Iraqi Postgraduate Medical Journal, 2014, Volume 13, Issue 2, Pages 195-201

ABSTRACT:
BACKGROUND:
Preterm labour is a major cause of perinatal morbidity and mortality, so it is important to predict preterm delivery using the clinical examination of the cervix and uterine contraction frequency. New markers for the prediction of preterm birth have been developed such as transvaginal ultrasound measurement of cervical length as this method is widely available.
OBJECTIVE:
To determine, whether transvaginal cervical length measurement predicts imminent preterm delivery better than digital cervical length measurement in women presented with preterm labour and intact membranes.
PATIENTS AND METHODS:
Two hundred women presented with preterm labour between 24 and 36+6 weeks of gestation were included in this study. All women subjected for digital and transvaginal ultrasound cervical length measurement and the outcome measures were occurrence of preterm delivery within 48 hours and within 7 days.
RESULTS:
Assessment of cervical length measurement using transvaginal ultrasound for the 200 women presented with preterm labour with intact membrane revealed that 8 (4%) delivered within 48 hours and 16 (8%) delivered within 7 days. According to the Bishop score, the test was positive if the Bishop score was ≥8, or 4-7 with cervical length ≤30 mm. The cut-off value for transvaginal ultrasound cervical length considered as 30 mm in the study group.
CONCLUSION:
Transvaginal sonographic measurement of cervical length can predict imminent preterm delivery in women presented with preterm uterine contractions and Bishop score between 4 - 7 compared with digital cervical length measurement.

Performance of Ultrasound as a Second Line Test to Serum Ca125 in Ovarian Cancer Screening in Postmenopausal Women

Nada Salih Amin; Asmaa Mohammed Abid

Iraqi Postgraduate Medical Journal, 2014, Volume 13, Issue 1, Pages 29-36

ABSTRACT:
BACKGROUND:
Epithelial ovarian cancer is uncommon before 40 years of age but the incidence then rises steeply until the mid sixth and seventh decades for which performance of transvaginal ultrasonography as a screening test for ovarian cancer in asymptomatic postmenopausal women with an elevated serum CA 125 had been performed.
OBJECTIVE:
Prospective ovarian cancer screening trial had been performed to estimate sensitivity, specifity and positive predictive value of different ultrasound criteria for detection of index cancer (e.g. primary invasive epithelial carcinoma of ovary) in postmenopausal women.
PATIENTS AND METHODS:
This study was carried out at the department of obstetrics and gynecology in AL-Yarmouk Teaching Hospital from October 2002 through October2003.The study included 110 Postmenopausal women ≥ 45 years, they underwent measurement of serum CA125.Women with CA 125 of 30 IU/ml (or more) were recalled for an ultrasound examination.
RESULTS:
Of the 110 women included in this study, 9 women underwent 30 scans during a follow up of one year. The sensitivity for detection of ovarian cancer of different ultrasound criteria was 100% for abnormal ovarian morphology, 100% for abnormal ovarian volume and 50% for complex abnormal ovarian morphology. The highest specificity (100%) and positive predictive value (100 %) was achieved by using complex abnormal ovarian morphology.
CONCLUSION:
A variety of ultrasound criteria had achieved high sensitivity, specificity and positive predictive value for ovarian cancer screening in postmenopausal women with an elevated CA 125. Ovarian morphology and ovarian volume used to interpret ultrasound had achieved increased sensitivity for ovarian cancer screening. While complex abnormal ovarian morphology had achieved increased in the specificity and the positive predictive value for ovarian cancer screening.
KEYWORDS: ovarian cancer, CA125, transvaginal ultrasound.

Determination of Endometrial Thickness Threshold for Prompt Biopsy in Postmenopausal Women Without Vaginal Bleeding

Nada S. Amen; Manal Madani Abdul Qader

Iraqi Postgraduate Medical Journal, 2012, Volume 11, Issue 3, Pages 292-296

ABSTRACT:
BACKGROUND:
Transvaginal sonography is performed as part of a pelvic sonogram in postmenopausal women and images of the endometrium are frequently obtained . In asymptomatic postmenopausal women without vaginal bleeding, the threshold separating normal from abnormally thickened endometrium is not known.
OBJECTIVE:
To determine an endometrial thickness threshold using transvaginal sonography for prediction of endometrial cancer in postmenopausal women without vaginal bleeding (asymptomatic) .
METHOD:
The study group includes 100 asymptomatic postmenopausal women without vaginal bleeding, We measure the sensitivity and specificity of trasvaginal sonography in the prediction of cancer in asymptomatic postmenopausal women without vaginal bleeding at endometrial thickness ≤5mm ,5-10 mm &>10mm ,
RESULTS:
Four cases (4) of cancer were detected at >10mm endometrial thickness. In asymptomatic postmenopausal women without vaginal bleeding the sensitivity 100% ,specificity 47.91% ,positive predictive values 7.40% and negative predictive values 100% at 10mm endomtrial thickness while at 5mm endomtrial thickness,the sensitivity 100% ,specificity 9.3% ,positive predictive values 4% and negative predictive values 100%
CONCLUSION:
In asymptomatic postmenopausal women promotion for endometrial sampling if endometrial thickness >10mm seen by trasvaginal sonography give better positive predictive value, sensitivity & specificity than>5mm endometrial thicknes