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Biomedical subjects

D J Lindsay

Publications and source records attributed to D J Lindsay.

At least 19 recordsLinked to original sources
PubMed1996

Yolk sac number, size and morphologic features in monochorionic monoamniotic twin pregnancy.

OBJECTIVE: To determine the relation between three characteristics of the yolk sac (number, size and morphologic features) and outcome in monochorionic monoamniotic twin pregnancy. METHODS: The authors reviewed data for the four sets of monochorionic monoamniotic twins detected by first-trimester ultrasonography between January 1990 and June 1994 at their institution. Data analysed included yolk sac number, size and morphologic features, as well as the outcome of the pregnancy. RESULTS: In all four sets of twins, only one yolk sac was identified. In one case the yolk sac was irregular in contour, and in two it was abnormally large. Two of the four mothers delivered healthy twins at 34 weeks gestational age, one had conjoined twins ( and underwent elective termination of the pregnancy), and one had a twin ectopic pregnancy (and underwent salpingectomy). CONCLUSION: A single yolk sac in cases of monochorionic monoamniotic twins may be a normal finding.

Adult↗
PubMed1994

Angiomyolipoma with lymph node involvement.

A renal mass accompanied by adenopathy was found incidentally in an asymptomatic 25-year-old woman. The computed tomography and ultrasonography findings suggested a malignant neoplasm. At pathological examination, however, renal angiomyolipoma was diagnosed; the lesion contained almost no fat and involved the lymph nodes, an unusual presentation for this tumour.

Adult↗
PubMed1993

Interstitial line: sonographic finding in interstitial (cornual) ectopic pregnancy.

PURPOSE: To evaluate the relationship of the endometrial canal and decidua vera to the interstitial gestational sac and to determine if this relationship can be used to increase the predictive value of ultrasound (US) in the diagnosis of interstitial ectopic pregnancy. MATERIALS AND METHODS: The US findings in 12 patients with interstitial ectopic pregnancy were reviewed. Radiologists also reviewed the cases of 40 patients with various diagnoses to assess the accuracy of the interstitial line sign. RESULTS: US showed a definite gestational sac in four of the 12 patients (33%); the rest had a heterogeneous mass in the cornual region. Thinning of the myometrial mantle was seen in these four patients. The gestational sac appeared eccentric in three of these but in only three of 12 (25%) overall. The endometrial canal or interstitial portion of the tube was identified in 11 of 12 patients (92%). The interstitial line had better sensitivity (80%) and specificity (98%) than eccentric gestational sac location (sensitivity, 40%; specificity, 88%) and myometrial thinning (sensitivity, 40%; specificity, 93%) for the diagnosis of interstitial ectopic pregnancy. CONCLUSION: The interstitial line sign is a useful diagnostic sign of interstitial ectopic pregnancy.

Adult↗
PubMed1993

Decidual cyst: endovaginal sonographic sign of ectopic pregnancy.

PURPOSE: To determine the prevalence of decidual cysts in patients with ectopic pregnancy and assess the value of endovaginal sonographic demonstration of decidual cysts in predicting ectopic pregnancy. MATERIALS AND METHODS: A series of 288 proved ectopic pregnancies was reviewed, and a series of 179 patients with pregnancies of less than 8 weeks menstrual age was prospectively examined. RESULTS: Decidual cysts were identified in 30 (14.4%) of 208 ectopic pregnancies. In 12 patients a decidual cyst was the first sonographic sign of ectopic pregnancy, and in six patients it was the only abnormal sonographic finding. Four of five patients with decidual cysts had an ectopic pregnancy. Decidual cysts had a sensitivity of 21%, specificity of 92%, positive predictive value of 80%, and negative predictive value of 42% in the diagnosis of ectopic pregnancy. CONCLUSION: Patients with decidual cysts are at high risk for ectopic pregnancy and should be monitored or treated appropriately, depending on the clinical findings.

Adult↗
PubMed1992

Yolk sac diameter and shape at endovaginal US: predictors of pregnancy outcome in the first trimester.

Four hundred eighty-six consecutive women who underwent endovaginal sonography when their fetuses were less than 10 weeks menstrual age (MA) were evaluated to establish the normal size and shape of the secondary yolk sac (YS) and to assess the value of YS measurement in predicting pregnancy outcome in the first trimester. A YS diameter more than two standard deviations (SDs) above the mean when compared with the mean gestational sac diameter allowed prediction of an abnormal pregnancy outcome with a sensitivity of 15.6%, a specificity of 97.4%, and a positive predictive value of 60.0%. A YS diameter more than two SDs below the mean allowed prediction of an abnormal outcome with a sensitivity of 15.6%, a specificity of 95.3%, and a positive predictive value of 44.4%. No pregnancy with a normal outcome had a YS diameter of greater than 5.6 mm at less than 10 weeks MA. In six patients, the YS diameter was greater than 5.6 mm. All six had an abnormal outcome. Of seven patients with abnormal YS shape at initial sonography, three had abnormal YS shape at follow-up examinations. All three had an abnormal outcome.

Abortion, Spontaneous↗
PubMed1992

Endovaginal and translabial ultrasound in pregnancy.

Endovaginal sonography provides earlier and enhanced visualization of the gestational sac and its contents than does transvesical sonography. This paper discusses the role of endovaginal sonography in common first trimester diagnostic problems, including pregnancy dating, first trimester pregnancy loss, ectopic pregnancy, and early diagnosis of fetal anomalies, and reviews the use of endovaginal color flow Doppler in the diagnosis of ectopic pregnancy. A brief discussion of the role of endovaginal and translabial sonography in the second and third trimesters is included.

Female↗
PubMed1991

Endovaginal sonographic diagnosis of ectopic twin gestation.

Endovaginal sonography has permitted earlier diagnosis of ectopic pregnancy. Twin ectopic pregnancy is rare. Until now, antenatal diagnosis of twin ectopic pregnancy using endovaginal sonography had not been reported. Three cases of twin ectopic pregnancy diagnosed via the intracavitary probe are presented.

Adult↗
PubMed1990

Contractions of the inner third of the myometrium.

Forty-six consecutive endovaginal ultrasound examinations were screened for the presence of myometrial contractions. The study group contained pregnant women up to 10 weeks' menstrual age, nonpregnant, and postmenopausal women. Rhythmic myometrial contractions of the inner myometrial third not previously reported were seen in 35 studies in pregnant, nonpregnant, and postmenopausal women. The contractions involved the inner third of the myometrium in all but two cases. In these two cases, all three muscular layers were involved. The majority of women showed retrograde contractions, with the contraction wave moving from the cervix to the fundus. In menstruating women and one case of abortion, the contractions were antegrade. It is our speculation that these retrograde contractions of the inner myometrial third may be important in sperm transport and for the conservation of early pregnancies within the uterine cavity.

Adult↗
PubMed1990

Endovaginal US: demonstration of cardiac activity in embryos of less than 5.0 mm in crown-rump length.

The authors reviewed the endovaginal ultrasonographic (US) findings for 96 patients with embryos with crown-rump lengths of less than 5.0 mm. Of the 71 patients with adequate follow-up, initial endovaginal US demonstrated cardiac activity in 46 embryos and no cardiac activity in 25. Initial endovaginal US failed to demonstrate cardiac activity in five of 40 normal embryos, three with crown-rump lengths of less than 2.0 mm and two, between 2.0 and 3.9 mm. Endovaginal US identified cardiac activity in all 12 normal embryos with crown-rump lengths of 4.0-4.9 mm. The presence of cardiac activity was associated with a 24% risk of spontaneous abortion. In embryos between 2.0 and 4.9 mm in crown-rump length, absent cardiac activity was associated with a 91% risk of abortion. All 17 patients with vaginal bleeding and embryos demonstrating no cardiac activity subsequently aborted. The embryonic yolk sac was absent in 35% of patients who subsequently aborted. Variation outside of the 95% confidence limits of the mean for crown-rump length compared with mean gestational sac diameter and yolk sac diameter was also helpful in predicting an abnormal outcome. Nonvisualization of cardiac activity at endovaginal US in embryos less than 4.0 mm in crown-rump length may be normal and warrants follow-up US examination.

Abortion, Spontaneous↗
PubMed1990

Ultrasound in the first trimester of pregnancy.

High-resolution sonography, including transvesical and endovaginal techniques, has resulted in enhanced visualization of embryonic and extraembryonic structures. With endovaginal sonography, the gestational sac may be seen within the decidua at about 4.5 weeks menstrual age. The yolk sac is the first structure to be seen within the gestational sac, and confirms the presence of a gestational sac rather than a decidual cast. The embryo is identified by endovaginal sonography early in the 6th week, and cardiac activity is routinely identified by a crown-rump length of 3 to 5 mm. On endovaginal sonography, absent cardiac activity in an embryo having a crown-rump length of greater than 3 to 5 mm indicates embryonic death. With endovaginal scanning, a gestational sac of greater than 8 mm without a yolk sac, or greater than 16 mm without an embryo, also indicates a nonviable pregnancy. Routine sonography primarily to assess the menstrual age should be performed in the second trimester, when added clinically relevant information may be obtained. Although it is possible to diagnose some anomalies in the first trimester, most remain second trimester sonographic diagnoses.

Congenital Abnormalities↗
PubMed1988

Early diagnosis of nonviable pregnancy with endovaginal US.

The mean diameter of the gestation sac and the presence or absence of a yolk sac or embryo and/or cardiac pulsations on endovaginal ultrasound (US) images were correlated with normal and abnormal outcomes of pregnancy. Sixty-two patients who were less than 10 weeks pregnant (menstrual age) underwent endovaginal US. In 59 patients with gestation sacs greater than or equal to 8 mm, the absence of a yolk sac predicted a nonviable pregnancy with a sensitivity of 67% and a specificity of 100%. In 35 patients with gestation sacs greater than or equal to 16 mm, the absence of an embryo predicted a nonviable pregnancy with a sensitivity of 50% and a specificity of 100%. When the absence of cardiac pulsations was added to the latter group of patients, the sensitivity was 100% and the specificity was 100%. The combination of these criteria (gestation sac size; demonstration of yolk sac, embryo and/or cardiac pulsations) enabled the early (less than 10 weeks menstrual age) diagnosis of a nonviable pregnancy with endovaginal US.

Amnion↗
PubMed1988

Suspected ectopic pregnancy: endovaginal and transvesical US.

Until the advent of endovaginal ultrasonography (US), transvesical US was the only US technique availab le for evaluation of patients with suspected ectopic gestation. A study was undertaken to assess the predictive ability of transvesical and endovaginal US and determine whether endovaginal US could be used alone. Fifty-three patients who had a positive pregnancy test finding and who were at risk for ectopic pregnancy were examined with both endovaginal and transvesical US. Twenty-nine were examined retrospectively and 24 were examined prospectively. Standard sonographic criteria were used to differentiate between intrauterine pregnancy and ectopic gestation. The clinical or pathologic diagnosis was ectopic pregnancy in 18 patients (34%), normal intrauterine pregnancy in 19 (36%), and abnormal intrauterine pregnancy in 16 (30%). Endovaginal US increased the sensitivity of detecting a live ectopic pregnancy (from 6% to 17%). Endovaginal US, by allowing early diagnosis of intrauterine pregnancy, significantly increased the diagnostic accuracy for ectopic pregnancy (from 60% to 83%). Endovaginal US provided significant additional information in women referred for sonography with a suspected ectopic gestation. On the basis of these findings it is concluded that endovaginal US can be used alone in the majority of women with suspected ectopic gestation.

Female↗