ULTRASOUND
The role of ultrasound in diagnosing miscarriages is vital
The results of the study conducted by Bottomley and Bourne13
correspond with these findings and state
that normal and abnormal pregnancies have been found to have similar gestational sac volumes when imaged using 3D ultrasound. Bottomley and Bourne13 state that there should be further investigation into the use of 3D imaging for diagnosing the causes for miscarriage. Therefore, various authors agree that when
diagnosing miscarriages, the most reliable and effective modality and methods of imaging are traditional 2D ultrasound and TV scans. Combining these methods, enables the detection of intrauterine gestation and viability at an early stage of pregnancy, with no known effects on the fetus3,13
. THE FUTURE
Ultrasound is constantly developing and improving, and this will certainly result in improving the scope for integration into clinical practice34
.
With regard to reducing the number of unplanned admissions and emergency surgical interventions which arise after the patient has chosen expectant management, various studies suggest the use of traditional 2D and 3D ultrasound imaging to assess how successful expectant miscarriage will be27,3 The study conducted by Zhang et al29
. , also suggests
measuring the endometrial thickness using TV scans to determine the success rate of medical management. However, the study by Singh et al35
states that there has
been no consensus among literature of a minimum endometrial thickness required for a successful pregnancy. Therefore until this stage, it cannot be used for determining the success of the various methods of management. Currently, MRI is used for imaging clinically serious
fetal abnormalities; nevertheless, the study by Chung et al36
suggests the use of MRI for fetal imaging as it
provides excellent soft tissue detail, resolution and can be very useful in terms of imaging suspected fetal abnormalities. However, ultrasound has significant advantages over MRI; for example, it is less expensive, faster and is mobile, so therefore patients can be imaged in the ward environment36
.
CONCLUSION As ultrasound is relatively low cost and fast, it can provide the patient with an instant answer as to the symptoms they may be experiencing, whether they have miscarried or not. The role of ultrasound in diagnosing miscarriages is vital; it not only provides a method of imaging the fetus with no known effects, but it also provides information needed to diagnose the type of miscarriage7
. In addition, TV scans should
be used in all early trimester viability scans, as it has the ability to visualise the fetus at a much earlier stage
JUNE 2017 23 HOW TO USE THIS ARTICLE FOR CPD
• What are the common barriers to communicating bad news to patients?
• Why is it important that sonographers have an adequate understanding of miscarriages?
• Ultrasound services are now in high demand – what workforce planning is required to support this?
REFERENCES
http://www.sor.org//learning/library- publications/itp
This article has been prepared following local guidance relating to the use of patient data and medical images.
To comment on this article, please write to
editorial@itpmagazine.co.uk
than transabdominal13 . Alternative imaging methods should only be used if
there is not enough diagnostic information available from the traditional 2D ultrasound or TV scans, as alternative methods such as MRI and Colour Doppler could potentially cause harm to the embyro13
. ABOUT THE AUTHOR
Cíara Williams is a Diagnostic Radiographer at the Nottingham University Hospitals and a graduate of University of Derby.
QA Code: FB2955DB
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