Differential diagnosis of intrauterine hydrocephalus includes various types of cerebral malformations. In about 30% of cases the pathogenesis remains unknown. During 1983-1985 we diagnosed intrauterine posthaemorrhagic hydrocephalus (IPHH) in four newborns. In three of the reported cases intraventricular haemorrhage (IVH) could already be proven in the fetus. Due to these observations, IPHH has to be considered with the differential diagnosis of congenital hydrocephalus. Haemorrhagic diathesis and multiple pregnancy are discussed as possible risk factors for this severe fetal complication.
The total of 160 patients with newly diagnosed invasive cancer of the cervix had whole body radioisotope bone scanning during staging of their disease. 51 patients had cancer of the cervix stage I, 63 had stage II, 34 stage III and 12 stage IV (FIGO). Only in 8 of 160 patients did the bone scans indicate possible metastases and this was confirmed by X-ray examination in only one patient with stage IV disease and liver metastases. We conclude that patients with stage I and stage II carcinoma of the cervix do not need to have bone scans.
In 1168 women patients operated on between January 1981 and July 1984 at the Department of Gynaecology of the University of Tübingen it was possible to control retrospectively the suspected diagnoses that had been made preoperatively, both clinically as well as sonographically, the control being based on an examination of the site of operation and/or the histological preparation. Sonographic examination was mostly effected after clinical examination while being aware of the clinically suspected diagnosis. Preoperative clinical diagnosis was found to be mostly correct in 816 patients (69.9%). After subsequent sonographical examination the proportion of correct diagnoses rose to 961 cases (82.3%). The diagnostic "positive addition"--a total of 145 cases (12.4%)--represents a significant improvement in preoperative clinical diagnosis (p less than 0.001), especially also in the diagnosis of carcinoma of the ovary (p less than 0.05). No impairment of sonographic diagnosis was seen as a result of obesity. In addition, it was also possible to clarify by sonography another 73 cases of 107 that had remained unclear after clinical examination (68%). The results are discussed in detail, broken down according to 19 typical gynaecological diagnoses. For the clinician it is quite evident that there are clear indications for the additional use of sonography after clinical examination. In the following prospective part II of the study this result is analyzed in respect of its causes by clinical and sonographic examination conducted independent of each other.
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