Routine Ultrasound Scanning in Midpregnancy. David W. Wetrich. Obstet. Gynecol., 1982, 60: 309-3 13.
THE MIDPREGNACY scanning with ultrasound of 2,009 patients was studied. The ultrasonographic examination was performed between 20 and 24 weeks of gestation by a nurse technician using the ADR real-time scanner. Patients were classified into three groups: those with uncertain estimated dates of confinement, those with complications and the normal patients. The latter group consisted of 1 ,453 patients.
The procedure accurately predicted the estimated date of confinement within 14 days of the date estimated by the last menstrual period of 94 per cent of the patients. it reduced the incidence of postdate pregnancy by 40 per cent and reduced the use of amniocentesis for maturity studies by 80 per cent. It was helpful in facilitating the diagnosis and management of 16 percent of the patients who required late pregnancy intervention and revealed that approximately one in 40 pregnancies was seriously misdated. The procedure was also helpful for diagnosing twin gestation in 90 per cent of the patients before delivery.
William J. Peeples
The Use of the CAT Scanner in the Management of Patients with Head Injury Transferred to the Regional Neurosurgical Unit. R.V. Jeffreys and Leandro Lozada. Injury, 1982, 13: 370-374.
THE AUTHORS review their experience with the treatment and management of 204 patients with severe trauma to the head who were transferred or directly admitted to a regional neurosciences center. They found that 57 per cent of patients with abnormal scans did not require operation, since it would not have helped the parenchymal lesions. In addition, no deterioration in morbidity or mortality was found from the reduction in surgical procedures associated with using computed tomography rather than angiography in the decision making process.
Herbert M Goldberg