[Interventional ultrasound in obstetrics and gynecology]

During 1988 there were 1029 invasive obstetrical and gynecological ultrasonically guided procedures: 788 early amniocenteses and 84 late amniocenteses, 26 chorion villi sampling, 24 by transcervical and 2 by transabdominal route, 74 fetal blood sampling (chordocenthesis) mainly for fetal karyotyping, in 9 cases the assessment of the fetal acid-base status was the main indication for the procedure. There was one patient with the increased risk of epidermolysis bulosa in whom fetal skin biopsy was performed. Prostaglandine was administered intraamnially under ultrasound control in 44 cases, in which the second trimester termination of pregnancy was indicated for medical reasons. In 3 cases a huge polyhydramnion was evacuated and in one case of several fetal hydrocephaly, craniocentesis and aspiration of the cerebral fluid were performed. There was one selective fetocide in twin pregnancy with a large meningomyelocele in one twin. In one case of a nonimune fetal hydrops at the 27-week gestation, the aspiration of the accumulated fluid and the intraperitoneal injection of albumin at 27 and 34 weeks, respectively, were performed. A total number of 6 gynecological invasive ultrasonically guided procedures was done. Three of them were punctures of ovarian follicles as part of IVF programme, one puncture of a large simple ovarian cyst, and two aspirations of extrauterine pregnancy with the administration of Metotrexate.