1Dept Obstetrics and Gynecology, Dept Obstetrics and Gynecology, Chi Mei Foundation HospitalChi Mei Foundation Hospital11
College of Medicine, Taipei Medical UniversityCollege of Medicine, Taipei Medical University22
Institute of Clinical Medicine, College of Medicine, Institute of Clinical Medicine, College of Medicine, National Cheng Kung UniversityNational Cheng Kung University33

•• : : ––
•• : : ––
•• : : ––
•• : : ––
History of Ultrasound in Obstetrics History of Ultrasound in Obstetrics and Gynecology and Gynecology
• The underwater SONAR, the RADAR and the ultrasonic Metal Flaw Detector were each, in their unique ways, a precursor of medical ultrasonic equipments.
• The modern ultrasound scanner embraces the concepts and science of all these modalities.
biparietalbiparietal diameterdiameter (BPD)(BPD)
Reproductive TechnologyReproductive Technology •• UrogynecologyUrogynecology and Pelvic Floor Reconstructionand Pelvic Floor Reconstruction
Maternal Fetal MedicineMaternal Fetal Medicine
Early pregnancyEarly pregnancy
Early PregnancyEarly Pregnancy
•• Head and faceHead and face
HeadHead
HeadHead
FaceFace
AcraniaAcrania
•• Spine, chest and abdomenSpine, chest and abdomen
Neck and spineNeck and spine
HeartHeart
• Four-chamber view
left ventricle (LV), right ventricle (RV), mitral valve (MV), tricuspid valve (TV), left atrium (LA), right atrium (RA), descending aorta (Ao), pulmonary vein (PV), the fetal spine(Sp) & rib.
AbdomenAbdomen
HydropsHydrops
•• Cord, kidney and extremityCord, kidney and extremity
Long boneLong bone
humerus skull rib
Boy or girlBoy or girl
Cervix and cordCervix and cord
Cervix Umbilical Cord
Color DopplerColor Doppler
33--D UltrasoundD Ultrasound
33--D UltrasoundD Ultrasound
A real ultrasound picture of Ryan, 3 months before birth.
Another picture of Ryan, 6 months after his birth.
Cleft lipsCleft lips
44--D UltrasoundD Ultrasound
•• able to look at the face and movements of your able to look at the face and movements of your baby before birth baby before birth
're-assurance scans' and the rather misnamed 'entertainment scans'
• Appearance (Color) • Pulse (Heart Rate) • Grimace (Response to Stimulation) • Activity (Muscle Tone) • Respiration (Respiration)
APGAR score vs Biophysical profileAPGAR score vs Biophysical profile
Interventional Interventional
EndometriumEndometrium
SubmucousSubmucous myomamyoma
Wu MP et al 1999 J Clin Ultrasound
OvaryOvary
DermoidDermoid cystcyst
Color flow ultrasound imaging showing normal ovarian flow. Ultrasound image showing ovarian follicles (pockets).
Ovarian cancerOvarian cancer
•• Polycystic ovaryPolycystic ovary •• FolliculometryFolliculometry •• TransvaginalTransvaginal ovum retrieval (TVOR)ovum retrieval (TVOR) •• Ovarian Ovarian hyperstimulationhyperstimulation syndrome (OHSS)syndrome (OHSS)
Polycystic ovary syndromePolycystic ovary syndrome
TransvaginalTransvaginal ovum retrieval (TVOR)ovum retrieval (TVOR)
FolliculometryFolliculometry
BicornuateBicornuate uterusuterus
US in UGUS in UG--PFRPFR
At rest Valsava
At rest Valsava
at rest; beginning of the cough; maximal cough pressure; leakage
Burch Burch colposuspensioncolposuspension
The most difficult thingThe most difficult thing--but an essential one is to but an essential one is to love life,love life,
to love it even while one to love it even while one suffers,becausesuffers,because life is all,life is all, life is God, and to love life means to love God.life is God, and to love life means to love God.
(Tolstoy; War and Peace)(Tolstoy; War and Peace)

(() )
Breast cystOther applicationsOther applications
Thank you !
APGAR scoreAPGAR score •• Heart Rate:Heart Rate:
–– a. Absent heartbeat = 0.a. Absent heartbeat = 0. b. Slow heartbeat (less than 100 beats per minute) = 1. b. Slow heartbeat (less than 100 beats per minute) = 1. c. Adequate heartbeat (more than 100 beats per minute) = 2. c. Adequate heartbeat (more than 100 beats per minute) = 2.
•• Respiration: Respiration: –– a. Not breathing = 0.a. Not breathing = 0.
b. Weak cry, irregular breathing = 1.b. Weak cry, irregular breathing = 1. c. Strong cry = 2. c. Strong cry = 2.
•• Muscle Tone:Muscle Tone: –– a. Limp, flaccid = 0. a. Limp, flaccid = 0.
b. Some flexing or bending = 1.b. Some flexing or bending = 1. c. Active motion = 2. c. Active motion = 2.
•• Response to Stimulation (also called Reflex Irritability):Response to Stimulation (also called Reflex Irritability): –– a. No response = 0. a. No response = 0.
b. Grimace = 1. b. Grimace = 1. c. Vigorous cry or withdrawal = 2. c. Vigorous cry or withdrawal = 2.
•• Color: Color: –– a. Pale or blue = 0.a. Pale or blue = 0.
b. Normal color body but blue extremities = 1.b. Normal color body but blue extremities = 1. c. Normal color = 2. c. Normal color = 2.
Ultrasound

biparietal diameter (BPD)
Head
Head
Face
Acrania
Neck and spine
Long bone
Interventional
Submucous myoma
Intramural myoma
Reproductive Medicine and Assisted Reproductive Technology
Polycystic ovary syndrome
US in UG-PFR
US in urogynecology
US in Burch colposuspension
The most difficult thing-but an essential one is to love life,to love it even while one suffers,because life is all,life is
APGAR score