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At the Universitäts-Frauenklinik Köln (Cologne) 515 patients with gynecological symptoms underwent 597 clinical and ultrasound examinations; 224 patients had a subsequent laparotomy which offered means of checking the clinical and ultrasound findings. There was full agreement between ultrasound and clinical examination in 80%, partial agreement in 9%, and no agreement in 11%. Ultrasound provided information not gained by clinical means in 12%. In those patients subjected to operation clinical examination provided correct and complete diagnoses in 70% of patients, partially correct diagnoses in 19%, and wrong diagnoses in 11%. Ultrasound, however, provided correct diagnoses in 78%, partially correct diagnoses in 14%, and wrong diagnoses in only 8%. The results of ultrasound and clinical findings tallied in 51%, in 38% the ultrasonogram provided more precise information than palpation, and in 11% the clinical findings were more revealing than ultrasound examination. Additional valuable information was provided by 13% of ultrasonograms. Ultrasonography was not a precise predictor of malignancy.

From August 1988 to October 1990, 115 transabdominal placental biopsies were performed in the second (68%) and third trimenon (32%). The main indication (80%) was the detection of pathological ultrasonographic findings (foetal malformation, growth retardation, oligohydramnios and polyhydramnios). The success rate of chorionic villus sampling (89%) was independent of the localisation of the placenta. A definite cytogenetic result was found in 83% of patients. By combination of placental biopsy and amniocentesis (n = 77) karyotyping was successful in 97% of pregnancies. Chromosomal abnormalities were observed in 15 (13%) cases (7 autosomal and 2 gonosomal aneuploidies, 1 unbalanced translocation, 1 autosomal deletion, 4 structural variants). The outcome of the pregnancies was substantially influenced by the indication for the procedure and by the cytogenetic result. Foetal and peri-/neonatal losses were found in 53% (3% spontaneous abortions) of patients with sonographic abnormalities (n = 92) and in 9% (abortion rate 4%) of pregnancies with regular findings (n = 23). The pregnancy loss rates were 37.7% and 5.9%, respectively. The results confirm the clinical significance of placental biopsy in the management of pregnancies with pathological ultrasonographic findings.