Journal of Ultrasound in Medicine, Vol 9, Issue 9 519-524, Copyright © 1990 by American Institute of Ultrasound in Medicine
Use of endo-vaginal ultrasound to optimize visualization of the distal fetal spine in breech presentations
T. M. Weber, B. S. Hertzberg and J. D. Bowie
Department of Radiology, Duke University Medical Center, Durham, North Carolina 27710.
Endovaginal ultrasound was used to evaluate the spine of 13
second-trimester fetuses in which transbdominal images were considered
equivocal due to suboptimal visualization of the distal spine and where the
fetus was in a breech presentation. Endovaginal sonography demonstrated a
small defect in the distal spine and a meningomyelocele in one of the 13
cases. In all of the remaining 12 cases, endovaginal sonography resulted in
improved visualization of morphologic detail, providing sufficient
information regarding bony anatomy to exclude splaying of the posterior
elements. Additionally, in 10 cases the intact skin surface overlying the
distal spine, which was not seen by transbdominal sonography, was well
demonstrated by endovaginal ultrasound. The authors recommend that
endovaginal ultrasound be considered to optimize visualization of the
distal fetal spine when transbdominal images are inconclusive and the fetus
is in a breech presentation.
