La ultrasonografía endovaginal en obstetricia

  • Francisco José Sales Puccini
  • Alfredo Ariza Machado

Resumen

Este trabajo tiene como objetivo comprobar la aplicación de la US endovaginal (USE) en obstetricia, sus beneficios e inconvenientes en relación con la técnica abdominal, la utilidad diagnóstica en alteraciones embrionarias, fetal es, ovulares y maternas durante el embarazo, además de un análisis del futuro de la (USE) en el plano investigativo.

Para este estudio se seleccionaron pacientes entre abril de 1990 y octubre de 1991 de la Unidad de Alto Riesgo Obstétrico del Departamento de Ginecología y Obstetricia del Hospital Simón Bolívar que necesitasen un estudio ecográfico integral (US Abdominal y Endovaginal), según los parámetros antes mencionados, y se citaron a un programa secuencial de estudio ecográfico correlacionado con los hallazgos clínicos y paraclínicos de cada caso. Siendo este programa uno de los resultados de la política académica de nuestro postgrado de gineco-obstetricia consistente en vincular al servicio tecnología foránea mediante la colaboración de instituciones privadas.

En dicho estudio se utilizó un ultrasonógrafo PHILIPS de 256 grises de resolución con un transductor lineal de 4 MHZ, un sectorial de foco medio de 3.5 MHZ, y un endovaginal de 7.5 MHZ con un ángulo de visión de 90°. Las gráficas se imprimieron en un printer de papel termosensible de alta resolución. Se efectuó además como soporte teórico una revisión bibliográfica de más de 100 referencias entre 1987-1991 sobre temas como: los usos de la USE en el primer trimestre normal y patológico, su correlación con los niveles séricos de BHCG, el papel de la USE en el diagnóstico precoz de anomalías congénitas, su uso en la incompetencia cervical y placenta previa.

Todo esto compendiado en 8 capítulos e ilustrado con un reporte gráfico de 60 ilustraciones sobre nuestra experiencia en cada uno de estos temas.

Después de un año de estudios ecográficos correlacionados (clínico-imagenológico), no dudamos en concluir que la US Endovaginal marca una nueva era en el diagnóstico precoz en obstetricia y por ende en la terapéutica de la obstetricia moderna.

 

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Biografía del autor/a

Francisco José Sales Puccini

Residente de IV año de Ginecología y Obstetricia de la Escuela Colombiana de Medicina (E.C.M.).

Alfredo Ariza Machado

Profesor asistente del área bioclínica y postgrado de la E.C.M. y docente asignado a la coordinación del servicio de alto riesgo obstetrico del Hospital Simón Bolívar.

Referencias bibliográficas

PARTE I

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PARTE II

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PARTE III

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Lachlan CH. de Crespigny MD et al. TI: Early diagnosis of pregnancy failure with transvaginal ultrasound. Am. J. Obst-Gynecol. 1988: 159: 408-409.

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Bernaschek G. Rudelfoster et al. TI: Vaginal sonography VS. HCG seric in early detection of pregnancy. Am Journal of Obstetrics and Ginecology. 1988; March 158: (3 pt 1) .

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Cullen MT .. Green JJ .. Reece EA .. Hobbins JC. TI : A comparison of transvaginal and abdominal ultrasound in visualizing the first trimester conceptus. J . Ultrasound-Med. 1989:8 (10): 565 -569.

Clifford S .. Levi MD .. Edward A .. Lyons MD et al. TI : Ednovaginal VS: Demostration of cardiac activity in embryos of less than 5.0 mm. In Croan-Rump length. Radiology. 1990; 176: (7 1-74) .

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PARTE IV

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endovaginal sonographic findings correlated with human chorionic gonadotropin levels. Radiology 1988; 167: 6 19-622.

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Timor-Tritsch IE. et al. TI: Vaginal ultrasonography: a new testing method in obstetric and ginecology. Orv. Hetil. Jun. 1989; 4: (130) 23 .

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PARTE V

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Uitrasound Med. 1990; 8: 565-569.

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PARTE VI

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PARTE VII

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Farine D .. Fox HC .. Jakobson S. et al. TI: l s it really placenta previa? Eur. J. Obst.-Gynecol. Reprod. 1989; 3 1: 103-108.

Robert A .. Leerentveld MD. (Phd) .• et al. TI: Accuracy and safety of transvaginal ·sonographic placenta! localization: Obstetrics and Gynecology 1990; 76: 759-76 1.

Laingfe et al. TI: Placenta previa: False negative diagnoses J.C.U. 1981; 9: 109.

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Lavery-JP. Michigan State University. TI: Placenta previa. Clin.-Obstet.-Gynecol. 1990; 414-421.

Meclure N., Dornal-J. et al. TI: Early identification of placenta previa. Br.-Obstet.-Gynecol. 1990; 97 (JO): 959-961.

Fayes C. Laing. TI: Ultrasound evaluation of obstetric problems relating to the lower uterine segment and cervix. Textbook: Transvaginal Doppler Color. publishing in the USA by the Parthenon Publishing Group Inc. Chapter 30. 1991; 487-499.

Publicado
1993-03-31
Cómo citar
1.
Sales Puccini FJ, Ariza Machado A. La ultrasonografía endovaginal en obstetricia. Rev. Colomb. Obstet. Ginecol. [Internet]. 31 de marzo de 1993 [citado 28 de septiembre de 2020];44(1):65-6. Disponible en: https://revista.fecolsog.org/index.php/rcog/article/view/833
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