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- Alson, Sara, et al.
(författare)
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Prevalence of endometrioma and deep infiltrating endometriosis at transvaginal ultrasound examination of subfertile women undergoing assisted reproductive treatment
- 2022
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Ingår i: Fertility and Sterility. - : Elsevier BV. - 0015-0282. ; 118:5, s. 915-923
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To estimate the prevalence of endometrioma and deep infiltrating endometriosis (DIE), assessed by systematic transvaginal ultrasound examination, in women with subfertility accepted for their first assisted reproductive treatment and to describe the prevalence of endometriotic lesions in different anatomical locations of the pelvis. Design: Cross-sectional study. Setting: Reproductive Medicine Center, Department of Obstetrics and Gynecology, University hospital. Patient(s): A total of 1,191 women with subfertility aged 25–39 years accepted for their first assisted reproductive treatment between December 2018 and May 2021. Intervention(s): All women underwent a systematic transvaginal ultrasound examination. The endometriotic lesions visible on ultrasound examination were described according to the International Deep Endometriosis Analysis group consensus opinion for systematic approach to assess endometriotic lesions. Main Outcome Measure(s): Prevalence of endometrioma and DIE in women with subfertility and prevalence of endometriotic lesions in various anatomical locations of the pelvis. Result(s): Endometriosis prevalence was 21.8%, with endometriotic lesions found in 260 of the 1,191 women. Overall, 125 (10.5%) women had endometrioma and 205 (17.2%) women had DIE. Of these 260 women, 197 (75.8% of women with endometriosis) did not have any previous knowledge about having endometriosis. The most common location for endometriotic lesions was the uterosacral ligaments, with lesions found in 151 (12.7%) of all women. The second most common location was the ovaries containing endometrioma, found in 125 (10.5%) women. Most women had 1 (n = 121, 10.2%) or 2 (n = 82, 6.9%) endometriotic lesions. Conclusion(s): The prevalence of endometrioma and DIE in women with subfertility, diagnosed by systematic transvaginal ultrasound examination, was 21.8%. Of these, three-fourth of women had no knowledge about the presence of disease.
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- Arechvo, Anastasija, et al.
(författare)
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Fusion imaging in brain structure measurements on a fetus phantom, combining real-time ultrasound with magnetic resonance imaging
- 2021
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Ingår i: Australasian Journal of Ultrasound in Medicine. - : Wiley. - 1836-6864 .- 2205-0140. ; 24:3, s. 161-172
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To assess synchronisation of MRI and US in measuring foetus phantom head structures; inter-method, intra- and inter-observer differences on biparietal diameter (BPD), head diameter, anterio-posterior head diameter (HAP) and lateral ventricle structures (VS). Methods: Fusion Imaging (FI) has been performed by combining MRI and US simultaneously. Axial scans of 1.5 Tesla MRI on a foetus phantom were acquired and uploaded on a US machine (EPIQ 7G, Philips). A PercuNav US tracker allowed the system to recognise and display the position of the transducer. A fetal phantom tracker was used as a phantom reference. Real-time US of the phantom head was performed by synchronising the uploaded MRI images using different landmarks. Synchronisation has been assessed by taking measurements after rotating the US probe by 90. Measurements were taken by three different observers twice. Differences in measurements between MRI and US, inter-, intra-observer differences in all measurements were assessed. Results: BPD, HAP and VS measurements before rotation were 0.13 ± 0.06 cm, 0.46 ± 0.09 cm and 0.4 ± 0.23 cm (width) and mean 0.6 ± 0.25 cm (length) larger at MRI than at US using any number of landmarks. After US probe rotation VS were 0.3 ± 0.24 cm in width and 0.3 ± 0.27 cm in length. Intra- and inter-observer differences in all measurements were small. Conclusions: FI showed good synchronisation in measurements. BPD, HAP and VS were larger at MRI than US, likely a result of the way images are generated. Intra-, inter-observer differences between measurements were small. This can be important when reporting geometric measures from FI.
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- Fernlund, Anna, et al.
(författare)
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Predictors of complete miscarriage after expectant management or misoprostol treatment of non-viable early pregnancy in women with vaginal bleeding
- 2020
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Ingår i: Archives of Gynecology and Obstetrics. - : Springer Science and Business Media LLC. - 0932-0067 .- 1432-0711. ; 302:5, s. 1279-1296
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To identify predictors of complete miscarriage after expectant management or misoprostol treatment of non-viable early pregnancy in women with vaginal bleeding. Methods: This was a planned secondary analysis of data from a published randomized controlled trial comparing expectant management with vaginal single dose of 800 µg misoprostol treatment of women with embryonic or anembryonic miscarriage. Predefined variables—serum-progesterone, serum-β-human chorionic gonadotropin, parity, previous vaginal deliveries, gestational age, clinical symptoms (bleeding and pain), mean diameter and shape of the gestational sac, crown-rump-length, type of miscarriage, and presence of blood flow in the intervillous space—were tested as predictors of treatment success (no gestational sac in the uterine cavity and maximum anterior–posterior intracavitary diameter was ≤ 15 mm as measured with transvaginal ultrasound on a sagittal view) in univariable and multivariable logistic regression. Results: Variables from 174 women (83 expectant management versus 91 misoprostol) were analyzed for prediction of complete miscarriage at ≤ 17 days. In patients managed expectantly, the rate of complete miscarriage was 62.7% (32/51) in embryonic miscarriages versus 37.5% (12/32) in anembryonic miscarriages (P = 0.02). In multivariable logistic regression, the likelihood of success increased with increasing gestational age, increasing crown-rump-length and decreasing gestational sac diameter. Misoprostol treatment was successful in 80.0% (73/91). No variable predicted success of misoprostol treatment. Conclusions: Complete miscarriage after expectant management is significantly more likely in embryonic miscarriage than in anembryonic miscarriage. Gestational age, crown-rump-length, and gestational sac diameter are independent predictors of success of expectant management. Predictors of treatment success may help counselling women with early miscarriage.
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- Orlov, Sofie, et al.
(författare)
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Development of endometriosis and adenomyosis at long-term follow-up of women without abnormal findings at initial ultrasound examination.
- 2023
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Ingår i: ; , s. 298-298
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Konferensbidrag (refereegranskat)abstract
- Objectives: Investigate if women with symptoms suggestive of endometriosis and no abnormal ultrasound findings at initial examination develop endometriosis lesions or adenomyosis visible at ultrasound examination at long-term follow-up.Methods: One hundred women were included in this prospective cohort study performed at the Ultrasound Unit, Department of Obstetrics and Gynecology, Skåne University Hospital, Malmö, Sweden. An experienced ultrasound examiner performed transvaginal ultrasound examinations according to the International Deep Endometriosis Analysis (IDEA) group consensus protocol at five-yearlong-term follow-up. Direct and indirect features of adenomyosis were evaluated in accordance with the revised definitions of Morphological Uterus Sonographic Assessment (MUSA).Results: Endometriosis lesions at follow-up were found in eight women (8%, 95%CI 3.5-15.2%): endometrioma in seven women (7%, 95%CI 2.9-13.9%) and deep endometriosis in four women (4%, 95%CI 1.1-10.0%). Features of adenomyosis were observed in 13 women (13%, 95% CI 7.1-21.2%): direct features in six women (6%, 95%CI 2.2-12.6%) and only indirect features in seven women (7%, 95%CI 2.9-13.9%).Conclusions: Despite no prior signs of endometriosis and adenomyosis at initial ultrasound examination, endometriosis lesions were found in 8% and direct features of adenomyosis in 6% at long-term follow-up of women with symptoms suggestive of endometriosis and adenomyosis. These findings demonstrate that endometriosis lesions and adenomyosis visible at ultrasound develop during the five years period.
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- Orlov, Sofie, et al.
(författare)
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Long-term follow-up of women with endometriosis symptoms and normal ultrasound examination : do visible endometriosis lesions develop over time?
- 2023
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Konferensbidrag (refereegranskat)abstract
- Introduction: The natural course of endometriosis is not fully understood. The diagnostic delay in endometriosis is approximately 7-8 years. Prevalence of endometriosis increase with age, which might indicate a delay until visible endometriosis appear at ultrasound examination. Aim: Investigate if women with symptoms suggestive of endometriosis and no abnormal ultrasound findings at the first examination develop visible lesions at ultrasound examination during long-term follow-up up to eight years. Methods: This was a prospective cohort study performed at the Ultrasound Unit, Department of Obstetrics and Gynecology, Skane University Hospital, Malmo, Sweden. Women were examined with transvaginal ultrasound by an experienced ultrasound examiner at long-term follow-up. Endometriosis was assessed according to the International Deep Endometriosis Analysis group consensus protocol and reported according to the #Enzian classification. Results: In total, 100 women underwent follow-up examination. Endometriosis was found in 8 women (8%, 95% CI 3.5-15.2%); 4 women (4%) had endometrioma, 1 woman (1%) had deep endometriosis and 3 women (3%) had combination of endometrioma and deep endometriosis. Median time to follow up was 70 months (range 51-104 months). Laparoscopy because of suspected endometriosis was performed in 22 women (22%) during follow-up time, in 10 women (10%) peritoneal endometriosis was found and surgically treated. One woman (1%) was diagnosed with abdominal wall endometriosis. In women with previously diagnosed peritoneal endometriosis at laparoscopy, endometrioma was seen in one woman (1%) and deep endometriosis in one woman (1%) at follow-up ultrasound examination.Conclusions and impact: Endometriosis visible at ultrasound was found in 8% of symptomatic women at follow-up up to eight years.
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| 10. |
- Orlov, Sofie, et al.
(författare)
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Prevalence of endometriosis and adenomyosis at transvaginal ultrasound examination in symptomatic women
- 2022
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Ingår i: Acta Obstetricia et Gynecologica Scandinavica. - : Wiley. - 0001-6349 .- 1600-0412. ; 101:5, s. 524-531
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: Prevalence of endometriosis is commonly reported based on surgery findings and varies widely depending on study population and indication for surgery. Symptoms such as dysmenorrhea, pelvic pain, dyspareunia, dysuria, and dyschezia can be associated with endometriosis and adenomyosis. Transvaginal ultrasound examination is proposed to be the first-line diagnostic method, nevertheless there are no published ultrasound-based studies reporting prevalence of endometriosis and adenomyosis in symptomatic women other than those scheduled for surgery. The aim of this study was to determine the prevalence of endometriosis and adenomyosis as assessed by transvaginal ultrasound in women with symptoms suggestive of endometriosis and adenomyosis.MATERIAL AND METHODS: This is a retrospective cross-sectional study performed at a tertiary-care center including 373 symptomatic women who were systematically examined with transvaginal ultrasound by an experienced ultrasound examiner. Before ultrasound examination women filled in a questionnaire including self-assessment of the severity of their symptoms (dysmenorrhea, chronic pelvic pain, dyspareunia, dysuria, dyschezia) using a visual analog scale. Abnormal findings in the uterus, ovaries, bowel, urinary bladder, uterosacral ligaments, and rectovaginal septum were noted, and their size and location were described. Prevalence of endometriosis, adenomyosis, endometrioma, and deep endometriosis in different anatomical locations was reported.RESULTS: Prevalence of ovarian endometrioma and/or deep endometriosis was 25% and of adenomyosis was 12%. Prevalence of endometrioma was 20% and of deep endometriosis was 9%, for each location being 8% in the bowel, 3% in the uterosacral ligaments, 3% in the rectovaginal septum and 0.5% in the urinary bladder.CONCLUSIONS: In symptomatic women examined with transvaginal ultrasound by an experienced ultrasound examiner, ovarian endometrioma and/or deep endometriosis was found in one of four women and adenomyosis in one of nine women. Deep endometriosis was present in one of 11 women. Despite having symptoms, half of the women had no abnormal ultrasound findings.
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