Prenatal Positioning Flashcards
Radiologic investigation of the nonpregnant uterus, accessory organs, and vagina are denoted by the terms hysterosalpingography, pelvic pneumography, and vaginography.
PRENATAL RADIOGRAPHY
The procedure is performed to determine the size, shape, and position of the uterus and uterine tubes;
Hysterosalpingography
to investigate the patency of the uterine tubes in patients who have been unable to conceive.
Hysterosalpingography
to delineate lesions such as polyps, submucous tumor masses, or fistulous tracts;
Hysterosalpingography
involves the introduction of a radiopaque contrast medium through a uterine cannula.
Hysterosalpingography
which requires the introduction of a gaseous contrast medium directly into the peritoneal cavity
*Pelvic pneumography
rarely performed because of the development of ultrasonic techniques for evaluating the pelvic cavity.
Pelvic pneumography
*is performed to investigate congenital abnormalities, vaginal fistulae, and other pathologic conditions involving the vagina.
Vaginography
*media are used in examinations of the female genital passages.
Various opaque media
The water-soluble contrast media employed for intravenous urography are widely used for
hysterosalpingography and vaginography.
performed by a physician with spot radiographs made while the patient is in the supine position on a fluoroscopic table
Hysterosalpingography
Contrast examination of uterine cavity was 1st performed by
Rindifleisch (1910)
It must not be performed during the week before or after menstruation, when the endometrium is either engorged or denuded.
HysteroSalpingography
It is best carried out mid-cycle, when the possibility of irradiating an unrecognized pregnancy is minimal
• between the 4th and 10th day in a patient with regular 28 days cycle.
Hystero-Salpingography
Examination of the non-gravid/pregnant patient of the uterus and uterine tubes, following injection of CM.
Hystero-Salpingography
•Employed in the investigation of infertility
Hystero-Salpingography
•Hystero Salpingography Preparation?
•Should abstain from intercourse between booking the appointment and time of the examination unless she uses methods of contraception.
•NPO and micturate immediately before the examination
Hystero Salpingography position
AP
Lithotomy
Hystero salpingography technique
Light cold speculum is used, the anterior lip of the cervix is gripped by vulsellum forceps.
Hystero Salpingography device use to easy access to see inside of the body
Speculum
Pelvimetry
measure relative sizes of the maternal pelvis
Cephalometry
measures fetal head
The obstetrician needs to know the shape of the sacrum and the exact measurements of the true conjugate and pelvic outlet.
Pelvimetry and Cephalometry
is the distance between the upper inner border of the symphysis pubis and the sacral promontory.
True conjugate
distance between the lower inner border of the symphysis pubis and the tip of the sacrum.
Pelvic outlet-
Device consists of a metal ruler perforated at centimeter intervals and mounted on a small stand in such a way that it is always parallel with the plane of the film.
Colcher Sussman Method
The ruler can be rotated in complete circle and can be adjusted for height.
Colcher Sussman Method
Colcher Sussman Method position
AP ( supine)
Is the localization of the placental site and is usually undertaken in an attempt to demonstrate placenta previa.
• Ultrasound is the choice for this examination
• Must be used in in selected cases only
Placentography
External bleeding without pain in pelvis
Placenta previa
The uterine-wall, placenta, and amniotic fluid are of the same radiographic density but the placental site is distinguishable.
• Most reliable near full term
Soft Tissue Placentography
The physician inserts only the tip of the catheter into the vaginal orifice or by inflated balloon.
• The barium mixture or iodinated contrast is introduced with the syringe.
Vaginography
Vaginography position
Preliminary film AP
• Both Obliques
• Lateral
• CR vertical at the level of the upper of the pubic symphysis.
Patient is placed in Lithotomy position on the table.
• Foleys catheter is inserted into the vaginal and its 30 mI balloon is distended with air which fit into lower part of vagina.
Vaginography
Performed by introducing a CM into the vaginal canal,20-30 ml of thin barium sulphate or water soluble, for the investigation of fistulous communications with the intestine.
Vaginography
After the examination patient is instructed to expel the
CM and the canal is then cleaned by vaginal irrigation.
Vaginography
Is used in the investigation of congenital malformations and such pathologic conditions such as: 1) vesicovaginal; 2) enterovaginal fistulas and 3) diverticula
Vaginography
Vaginography Technique
Patient should empty her bladder immediately prior to the investigation.
•The measurement of the maternal pelvis are usually investigated in the 3rd trimester.
Pelvic Outlet Superoinferior Projection-Chassard Lapine Method
To disclose any displacement of the fetus.
• Normally the head of the fetus is in the midsagital and midcoronal planes of the pelvic inlet when the fetus is in cephalic presentation and the mother is standing.
Ball Method
AP Position
No special apparatus or accessories in exposing the films.
• Consists of two projections AP and Lateral
Ball Method
In ball method why Patient in the erect position.
• To utilize the effect of gravity upon the fetus.
Lateral position in Colcher Sussman Method cr
CR perpendicular most prominent point of the greater trochanter.
Lateral position in Colcher Sussman Method position of the ruler
Turn the ruler lengthwise, and adjust its height to coincide with the MSP
• Ruler within the upper part of the gluteal fold and against the midsacrum.
•CR horizontally directed to superior margin of the symphysis pubis
Ball method
