الفهرس 
Subject and methodsOnly 14 pages are availabe for public view
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Abstract
SUMMARY
Sonography IS considered the imaging procidure of choice in
evaluating patient with third-trimester bleeding. However, placenta
previa can be difficult to diagnose with transabdominal sonography
during the third trimester of pregnancy.
Sonographic evaluation of 180 patients with third-trimester
bleeding was performed by using transperineal and transabdominal
sonographic technique. Transabdominal sonograms had been
inconclusive for placenta previa in 128 of these patients because the
cervix was not visulaized, the remainng 52 had transabdominl scan that
show placenta previa. Transperineal sonography successfully visualized
the internal surface of the cervix in all 180 cases allowing determination
of the presence of absence of placenta previa in all cases. Transperineal
sonograms showed the absence of placenta previa in 122 cases. At
delivery nene of these patients had evidence of placenta previa.
Transperineal sonography showed placenta previa in 58 patients. In 55 of
these cases, placenta previa was confermed at delivery. The other 2
patients did not have clinically significant placenta previa at delivery.
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CONCLUSION
Transperineal sonography is a safe accurate and rapid technique to
complement transabdominal sonography for evaluation of patients with
third-trimester bleeding with patient acceptence and tolerance, without
the need of vaginal penetration or manipulation of the cervix which is
very important in such cases.
Transperineal somography should not replace transabdominal
sonography in evaluation of patient with placenta previa. Sonography in
these cases nequires visualization of both the inferior edge of the
placenta and the cervix. The cervix is almost always seen on trans
perineal sonograms, but the lower edge of the placenta is usually the
feild of vew. In such cases transabdominal sonograms facilitate
visualization of the lower edge of the placenta.
Use of transperineal should be strongly considered when a
definitive diagnosis regarding placenta previa is not possible by
transabdominal sonography becanse the cervix is not visualized. In sbich
. cases, trarsperineal sonography will usually show the internal surface of
the cervix without overlying placental tissue, allowing confident
exclusion of placenta previa. Occasionally, however, transperineal
sonography will show a placenta previa that was not seen with
transabdominal sonography.
This technique is important in obstetric practice and needs further
study to ralidate its potential application in other obstetric pnblems as
PROM or cervical in comptence.