We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.
To save content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about saving content to .
To save content items to your Kindle, first ensure coreplatform@cambridge.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
Ovulation induction using stimulation drugs has now been in practice for over 40 years. Until the introduction of ultrasound, monitoring of follicular growth was a difficult task. Transvaginal ultrasound is now the routine for ovulation induction monitoring. Transvaginal probes have a much higher frequency reaching 4–9 MHz, and have wider angles up to 180º and depths that could reach 16 cm, facilitating the procedure of monitoring.
Ovarian hyperstimulation syndrome (OHSS) is the most serious iatrogenic complication of ovulation induction. The ovaries are noted to have a significant degree of stromal edema, interspersed with multiple hemorrhagic follicular and theca-lutein cysts, areas of cortical necrosis, and neovascularization. Mutations in follicle-stimulating hormone (FSH) receptors could be activating, resulting in OHSS, or inactivating, resulting in sterility. Bone morphogenic protein-15 (BMP-15) appears to be associated with mechanisms of infertility and superfertility in a dosage-sensitive manner. Human chorionic gonadotropin increases vascular endothelial growth factor (VEGF) production by granulosa cells and endothelial cells, which results in increased vascular permeability. Increased intraovarian blood flow and low intravascular ovarian resistance are correlated with the severity of OHSS in patients who develop the syndrome. The medical treatment of OHSS consists of correction of circulatory volume and electrolyte imbalance. Ultrasonographic guidance of transvaginal or transabdominal aspiration of ascites improves the symptoms of patients with OHSS.
With the advancement of ultrasound (US) technology with introduction of 3D technology as well, detailed examination of the uterine cervix, anatomy, and accurate measurements have become possible. Benign gynecologic conditions seen by US in non-pregnant state include nabothian cysts, cervical polyps, fibroids and Mullerian anomalies. The importance of transvaginal US in diagnosing placenta previa lies also in the ability by transvaginal US to determine exact distance of placental edge from internal os, which will consequently determine mode of delivery. US is the main diagnostic tool for cervical pregnancy. Doppler is a very important tool as well, due to its difficult diagnosis, it should be differentiated from the cervical stage of spontaneous abortion and nabothian cyst and cervical choriocarcinoma. The risks of cervical pregnancy are mainly severe hemorrhage, necessitating hysterectomy in many situations, and it usually occurs in nulliparous or low-parity women, adding to the dilemma of management.
Recommend this
Email your librarian or administrator to recommend adding this to your organisation's collection.