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    Womb with a view: How to prepare for tomorrow’s ob/gyn images



    Dr Levine is Practice Director at the Colorado Center for Reproductive Medicine, New York, New York.


    As obstetricians and gynecologists we must know not only obstetrics and gynecology but also a significant amount of internal medicine, general surgery, and radiology. Knowing which radiologic test to order is not enough; many of us routinely make clinical decisions and perform procedures based solely on our own ultrasonographic findings.

    Ultrasound was first introduced to ob/gyn in the late 1950s in an article published by Dr Ian Donald in the Lancet. In this sentinel paper, Donald described how an image of a fetus could be produced on a cathode ray tube by rocking a transducer slowly over a woman’s abdomen. This early image was bistable (meaning that it lacked any gray scale so it was completely black and white).1

    It was Donald and his team who first described the early diagnosis of a hydatid mole, identification and assessment of early gestation, and presence of pelvic masses.2 In the years that followed, these investigators also made great advances in describing the location of the placenta. That was viewed as a paramount discovery because hemorrhage from placenta previa was then a significant cause of maternal and fetal morbidity and mortality.3

    It has been more than 55 years since ultrasound was first described, and today’s tools and techniques barely resemble the initial construct. Ultrasounds are now performed in real time, transvaginal transducers allow for improved pelvic sonographic studies, and 3D constructs are a common component of fetal anatomical screening.

    For example, GE Healthcare announced last year that it had released a machine (the Voluson E10) that in the company’s words has “4 times the ultrasound pathways for improved clarity with increased penetration, 10 times the data transfer rates for more speed, higher resolution and very fast frame rates, and 4 times the processing power for more flexibility with advanced applications and efficient workflow.”

    Brian A. Levine, MD, MS, FACOG
    Dr. Levine is Practice Director at the Colorado Center for Reproductive Medicine, New York, New York.


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