Radiology, Vol 179, 747-750, Copyright © 1991 by Radiological Society of North America
Transperineal US: alternative technique to improve visualization of the presenting fetal part
TM Weber, BS Hertzberg and JD Bowie
Department of Radiology, Duke University Medical Center, Durham, NC 27710.
Transperineal ultrasound (TPU) was used as an alternative imaging technique
to evaluate the anatomy of the presenting part in 27 second- and
third-trimester fetuses when transabdominal ultrasound (US) images were
suboptimal. Use of TPU improved visualization of the distal fetal spine in
20 of 21 breech cases, providing sufficient information regarding bone
anatomy to rule out splaying of the posterior elements. In addition, the
intact skin surface overlying the distal spine, not seen at transabdominal
US, was well demonstrated at TPU in 18 of these fetuses. TPU was used to
improve assessment of intracranial anatomy in six cases with a cephalic
presentation in which the fetal head was located low in the maternal pelvis
and could not be adequately visualized with the transabdominal technique.
In one of these cases, TPU offered improved visualization of anencephaly.
Use of TPU should be considered to optimize visualization of the presenting
fetal part when results at transabdominal US are suboptimal and the poorly
seen part overlies the maternal cervix.
