Biomedical subjects
Publications and source records attributed to E Svalenius.
Pregnancy in a rudimentary horn of a bicornuate uterus is a rare and often fatal event. A case is presented of such a pregnancy detected in the second trimester routine ultrasonographic examination.
The ovaries of 377 women between the age of 40 and 70 years were measured by ultrasound. About one third of the patients were postmenopausal. Mean value, standard deviation and S.E.M. of the ovarian volume were calculated and related to age, parity and menstrual cycle. Ovarian size decreased with age in all women but bore no relation to parity and day of menstrual cycle in the menstruating group of women over 40 years of age. A diagram of the ovarian volume related to age is presented. In postmenopausal women the volume was related to estrogen treatment, age, parity and years since menopause. In the group of women receiving orally administered estrogens for at least a year the p-values for all parameters were greater than 0.005. Furthermore, the ovarian volume of women under hormonal treatment did not decrease with age. On the other hand the most important factor for ovarian size in subjects not receiving estrogen treatment was age (p = 0.0056). The results presented here will serve as a prerequisite for sonar examination of the ovaries in women at high risk for development of ovarian carcinoma.
Ultrasound scan for detection of ovarian enlargements was performed in a target group of out-patients attending the clinic for various reasons in the 40-70 years range. Overall 805 women were examined, in 99% of whom the ovaries and/or their vessels could be identified. Pathological findings were suspected in 83 patients at the first scan, and were confirmed in 50 after a repeat scan, 39 of whom subsequently underwent surgery. Various ovarian lesions were found in 35 women, including five mucinous and serous cystadenomas, one carcinoma, two borderline tumours, and a cancer of the caecum. None of the borderline or malignant ovarian lesions were found by manual pelvic examination. Ultrasound screening appears to be a useful diagnostic aid, though its usefulness might be further improved if other risk factors such as heredity and period of ovulatory activity are taken into consideration.
Placental grading was studied prospectively with real-time ultrasound in 654 consecutive pregnancies. The placental maturation was clearly demonstrated in both unselected and hypertensive pregnancies. No differences in placental grading were found between normotensive and hypertensive pregnancies. Fetal outcome was not associated with different placental grades and a grade III placenta was not predictive of an adverse outcome. The value of antenatal placental grading in unselective and hypertensive pregnancies could not be demonstrated.
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A prospective longitudinal investigation of spontaneous cephalic version from breech presentation in the last trimester is reported. All pregnancies were assessed with ultrasound in the 32nd week of gestation, and were thereafter checked weekly. Of the 310 singleton breech presentations identified at 32 weeks, spontaneous cephalic version occurred in 177 (57%) while breech presentation persisted in 133 patients (43%). Of 140 patients with a breech presentation at delivery 95% were already presenting by the breech in the 32nd week. Spontaneous cephalic version was less likely in pregnancies with extended fetal legs, low birth-weight, short umbilical cord and primiparity.
Real-time ultrasound was used in 654 consecutive pregnancies to obtain standard growth parameters for the fetal brain. Measurement of the width of the lateral ventricle (LVW) and hemisphere and their relationships to menstrual age, biparietal diameter, and birth weight were determined. The growth of the LVW was to a great extent independent of birth weight but dependent on menstrual age. Thirteen fetuses with a single ventricular width measurements exceeding +2 SD from the mean were separately evaluated, and all but one case were found to be normal.
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