Gynecologic ultrasonography or gynecologic sonography refers to the application of medical ultrasonography to the female pelvic organs as well as the bladder, the adnexa, the recto-uterine pouch. The procedure may lead to other medically relevant findings in the pelvis; the examination can be performed by transabdominal ultrasonography with a full bladder which acts as an acoustic window to achieve better visualization of pelvis organs, or by transvaginal ultrasonography with a designed vaginal transducer. Transvaginal imaging utilizes a higher frequency imaging, which gives better resolution of the ovaries and endometrium, but is limited to depth of image penetration, whereas larger lesions reaching into the abdomen are better seen transabdominally. Having a full bladder for the transabdominal portion of the exam is helpful because sound travels through fluid with less attenuation to better visualize the uterus and ovaries which lies posteriorly to the bladder; the procedure is by definition invasive.
Scans are performed by health care professionals called sonographers, or gynecologists trained in ultrasound. Gynecologic sonography is used extensively: to assess pelvic organs, to diagnose acute appendicitis to diagnose and manage gynecologic problems including endometriosis, adenomyosis, ovarian cysts and lesions, to identify adnexal masses, including ectopic pregnancy, to diagnose gynecologic cancer in infertility treatments to track the response of ovarian follicles to fertility medication. However, it underestimates the true ovarian volume. Through transvaginal sonography ovarian cysts can be aspirated; this technique is used in transvaginal oocyte retrieval to obtain human eggs through sonographic directed transvaginal puncture of ovarian follicles in IVF. Gynecologic ultrasonography is sometimes overused when it is used to screen for ovarian cancer in women who are not at risk for this cancer. There is consensus that women with only average risk for ovarian cancer should not be screened with this procedure for cancer.
Sonohysterography is a specialized procedure by which fluid sterile saline, is instilled into the uterine cavity, gynecologic sonography performed at the same time. A review in 2015 came to the conclusion that SIS is sensitive in the detection of intrauterine abnormalities in subfertile women, comparable to hysteroscopy. SIS is sensitive and specific test in the diagnosis of uterine polyps, submucous uterine fibroids, uterine anomalies and intrauterine adhesions, can be used as a screening tool for subfertile women prior to IVF treatment. Gynography Gynoroentgenology Obstetric ultrasonography Sonosalpingography Vaginal ultrasonography Information about Sonography
The pelvis is either the lower part of the trunk of the human body between the abdomen and the thighs or the skeleton embedded in it. The pelvic region of the trunk includes the bony pelvis, the pelvic cavity, the pelvic floor, below the pelvic cavity, the perineum, below the pelvic floor; the pelvic skeleton is formed in the area of the back, by the sacrum and the coccyx and anteriorly and to the left and right sides, by a pair of hip bones. The two hip bones connect the spine with the lower limbs, they are attached to the sacrum posteriorly, connected to each other anteriorly, joined with the two femurs at the hip joints. The gap enclosed by the bony pelvis, called the pelvic cavity, is the section of the body underneath the abdomen and consists of the reproductive organs and the rectum, while the pelvic floor at the base of the cavity assists in supporting the organs of the abdomen. In mammals, the bony pelvis has a gap in the middle larger in females than in males, their young pass through this gap.
The pelvic region of the trunk is the lower part of the trunk, between the thighs. It includes several structures: the bony pelvis, the pelvic cavity, the pelvic floor, the perineum; the bony pelvis is the part of the skeleton embedded in the pelvic region of the trunk. It is subdivided into the pelvic spine; the pelvic girdle is composed of the appendicular hip bones oriented in a ring, connects the pelvic region of the spine to the lower limbs. The pelvic spine consists of the coccyx; the pelvic cavity defined as a small part of the space enclosed by the bony pelvis, delimited by the pelvic brim above and the pelvic floor below. Each hip bone consists of 3 sections, ilium and pubis. During childhood, these sections are separate bones, joined by the triradiate cartilage. During puberty, they fuse together to form a single bone; the pelvic cavity is a body cavity, bounded by the bones of the pelvis and which contains reproductive organs and the rectum. A distinction is made between the lesser or true pelvis inferior to the terminal line, the greater or false pelvis above it.
The pelvic inlet or superior pelvic aperture, which leads into the lesser pelvis, is bordered by the promontory, the arcuate line of ilium, the iliopubic eminence, the pecten of the pubis, the upper part of the pubic symphysis. The pelvic outlet or inferior pelvic aperture is the region between the subpubic angle or pubic arch, the ischial tuberosities and the coccyx. Ligaments: obturator membrane, inguinal ligament Alternatively, the pelvis is divided into three planes: the inlet and outlet; the pelvic floor has two inherently conflicting functions: One is to close the pelvic and abdominal cavities and bear the load of the visceral organs. To achieve both these tasks, the pelvic floor is composed of several overlapping sheets of muscles and connective tissues; the pelvic diaphragm is composed of the coccygeus muscle. These arise between the symphysis and the ischial spine and converge on the coccyx and the anococcygeal ligament which spans between the tip of the coccyx and the anal hiatus; this leaves a slit for the urogenital openings.
Because of the width of the genital aperture, wider in females, a second closing mechanism is required. The urogenital diaphragm consists of the deep transverse perineal which arises from the inferior ischial and pubic rami and extends to the urogential hiatus; the urogenital diaphragm is reinforced posteriorly by the superficial transverse perineal. The external anal and urethral sphincters close the urethra; the former is surrounded by the bulbospongiosus which narrows the vaginal introitus in females and surrounds the corpus spongiosum in males. Ischiocavernosus clitoridis. Modern humans are to a large extent characterized by large brains; because the pelvis is vital to both locomotion and childbirth, natural selection has been confronted by two conflicting demands: a wide birth canal and locomotion efficiency, a conflict referred to as the "obstetrical dilemma". The female pelvis, or gynecoid pelvis, has evolved to its maximum width for childbirth—a wider pelvis would make women unable to walk.
In contrast, human male pelvises are not constrained by the need to give birth and therefore are more optimized for bipedal locomotion. The principal differences between male and female true and false pelvis include: The female pelvis is larger and broader than the male pelvis, taller and more compact; the female inlet is oval in shape, while the male sacral promontory projects further. The sides of the male pelvis converge from the inlet to the outlet, whereas the sides of the female pelvis are wider apart; the angle between
The uterine appendages are the structures most related structurally and functionally to the uterus. They can be defined in different ways: Some sources define the adnexa as the fallopian tubes and ovaries. Others include the supporting tissues". Another source defines the appendages as the "regions of the true pelvis posterior to the broad ligaments". One dictionary includes the fallopian tubes and ligaments; the term "adnexitis" is sometimes used to describe an inflammation of the uterine appendages. In this context, it replaces the terms salpingitis; the term adnexal mass is sometimes used when the location of a uterine mass is not yet more known. 63% of ectopic pregnancies present with an adnexal mass. Depending on the size of the mass, it could be a medical emergency. Term "Adnexectomy" in Gynaecology is used for Salpingo-Oophorectomy. Adnexa
International Standard Serial Number
An International Standard Serial Number is an eight-digit serial number used to uniquely identify a serial publication, such as a magazine. The ISSN is helpful in distinguishing between serials with the same title. ISSN are used in ordering, interlibrary loans, other practices in connection with serial literature; the ISSN system was first drafted as an International Organization for Standardization international standard in 1971 and published as ISO 3297 in 1975. ISO subcommittee TC 46/SC 9 is responsible for maintaining the standard; when a serial with the same content is published in more than one media type, a different ISSN is assigned to each media type. For example, many serials are published both in electronic media; the ISSN system refers to these types as electronic ISSN, respectively. Conversely, as defined in ISO 3297:2007, every serial in the ISSN system is assigned a linking ISSN the same as the ISSN assigned to the serial in its first published medium, which links together all ISSNs assigned to the serial in every medium.
The format of the ISSN is an eight digit code, divided by a hyphen into two four-digit numbers. As an integer number, it can be represented by the first seven digits; the last code digit, which may be 0-9 or an X, is a check digit. Formally, the general form of the ISSN code can be expressed as follows: NNNN-NNNC where N is in the set, a digit character, C is in; the ISSN of the journal Hearing Research, for example, is 0378-5955, where the final 5 is the check digit, C=5. To calculate the check digit, the following algorithm may be used: Calculate the sum of the first seven digits of the ISSN multiplied by its position in the number, counting from the right—that is, 8, 7, 6, 5, 4, 3, 2, respectively: 0 ⋅ 8 + 3 ⋅ 7 + 7 ⋅ 6 + 8 ⋅ 5 + 5 ⋅ 4 + 9 ⋅ 3 + 5 ⋅ 2 = 0 + 21 + 42 + 40 + 20 + 27 + 10 = 160 The modulus 11 of this sum is calculated. For calculations, an upper case X in the check digit position indicates a check digit of 10. To confirm the check digit, calculate the sum of all eight digits of the ISSN multiplied by its position in the number, counting from the right.
The modulus 11 of the sum must be 0. There is an online ISSN checker. ISSN codes are assigned by a network of ISSN National Centres located at national libraries and coordinated by the ISSN International Centre based in Paris; the International Centre is an intergovernmental organization created in 1974 through an agreement between UNESCO and the French government. The International Centre maintains a database of all ISSNs assigned worldwide, the ISDS Register otherwise known as the ISSN Register. At the end of 2016, the ISSN Register contained records for 1,943,572 items. ISSN and ISBN codes are similar in concept. An ISBN might be assigned for particular issues of a serial, in addition to the ISSN code for the serial as a whole. An ISSN, unlike the ISBN code, is an anonymous identifier associated with a serial title, containing no information as to the publisher or its location. For this reason a new ISSN is assigned to a serial each time it undergoes a major title change. Since the ISSN applies to an entire serial a new identifier, the Serial Item and Contribution Identifier, was built on top of it to allow references to specific volumes, articles, or other identifiable components.
Separate ISSNs are needed for serials in different media. Thus, the print and electronic media versions of a serial need separate ISSNs. A CD-ROM version and a web version of a serial require different ISSNs since two different media are involved. However, the same ISSN can be used for different file formats of the same online serial; this "media-oriented identification" of serials made sense in the 1970s. In the 1990s and onward, with personal computers, better screens, the Web, it makes sense to consider only content, independent of media; this "content-oriented identification" of serials was a repressed demand during a decade, but no ISSN update or initiative occurred. A natural extension for ISSN, the unique-identification of the articles in the serials, was the main demand application. An alternative serials' contents model arrived with the indecs Content Model and its application, the digital object identifier, as ISSN-independent initiative, consolidated in the 2000s. Only in 2007, ISSN-L was defined in the