胎嚢像の超音波断層所見および子宮内胎嚢像類似所見に関する考察

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  • Evaluation of ultrasonographic findings of gestational sac and the echogenic structures showing similar pattern to the intrauterine gestational sac.

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Since the advent of the real time B-mode scanning ultrasonic diagnostic method, observation of the embryonic heartbeat in the early stages of pregnancy became possible. Therefore, a fetus that was not expected to live, or a blighted ovum without an embryonic heartbeat as well as intrauterine death of the fetus were more easily identified. Subsequently, among the cases which were treated as threatened abortion, blighted embryo, or dead fetus resulting from chromosomal aberrations or embryonic abnormalities were found very frequently.<br>Diagnosis and prognosis of threatened abortion could be accurately determined by the ultrasonographic findings. The conceptus was identified in a normal pregnancy as a highly brilliant, record or spherical and regularly continuous, clear phasic circular structure in the lumen of the uterus. The highly brilliant circular structure derived from the gestational sac in the early phase of pregnancy displayed on the screen of ultrasonography was mainly derived from chronic tissue and was seen as a white ring. This structure was detectable during any time of the course of pregnancy after 6 weeks.<br>In addition, a healthy embryonic heart was identifiable on the display screen as a rhythmic, on and off flashing. This structure was almost always detectable by the last days of the eight week of pregnancy.<br>When the embryonic heart beat in a normal embryonic sac was detected, even if the sign of threatened abortion was present, the probability of an abortion was very low, and birth of the infant was expected in most of the cases.<br>From the above observations, if signs of threatened abortion was detected in the early stage of pregnancy, the differentiation of true threatened abortion from consequences of the blighted ovum or death of fetus was apparently important. In this occasion, a typical syndrome such as hydatidiform mole or partial hydatidiform mole was also often likely to occur and showed similar ultrasonographic findings.<br>In addition, the ultrasonographic findings similar to the picture of the intrauterine gestation sac in an ectopic pregnancy and/or the findings of fluid accumulation due to various conditions including inflammatory diseases of the endometrium and the accessory organs, menstruation, functional bleeding from the uterus should be noted.<br>From these observations, we tried to describe ultrasonographic findings of the various diseases including normal pregnancy, blighted ovum, hydatidiform mole as well as the conditions similar to the intrauterine gestation sac.

収録刊行物

  • 医療

    医療 42 (11), 1000-1006, 1988

    一般社団法人 国立医療学会

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