It will be a long time before the quality of this profusely illustrated book is overtaken and the present spate of books on the subject of obstetric ultrasound may, as a result, suffer a numerical set-back - especially with translation into English which will "deliver the milk on everyone's doorstep". Two of the authors studied in our department in Glasgow and worked like If there are any rewards for teaching, then we humble Scots who demons. have had the privilege have had more than our share as a result of the pride with which we regard our pupils. In my own old age and looking back over the last thirty years, the innumer able difficulties, set-backs and disappointments have been more than compen sated for by those who have turned the subject from a laughable eccentricity (as I have at one time experienced) into a science of increasing exactitude. This transformation has come about, not by any efforts of mine, but by the enthusiasm and ingenuity of those who would probably have achieved as much on their own if given the encouragement which I ultimately received in Glasgow University life. Limbo must be the expected lot of most of us ordinary mortals but the work lives on. And so, in this reminiscent and philosophical mood I beg leave to quote a little poem which I wrote at an age when young men do that sort of thing.

1 Physics and Instrumentation in Diagnostic Ultrasound

1.1 Propagating Properties of Ultrasound
1.2 Grey-Scale Sonography
1.2.1 Acoustic Impedance Mismatch
1.2.2 Attennuation by Tissue
1.3 Transducer Beam Pattern
1.3.1 Geometry of Reflecting Interfaces
1.3.2 Principle of Grey-Scale Sonography
1.4 Quality of Image and Frame Rate
1.5 Real-Time Scanning
1.6 Simple and Compound Scanning
1.7 Contact and Water-Path Coupling
1.8 Current Instrumentation
1.8.1 Articulated Arm Manual Contact Scanner
1.8.2 Linear Array Scanner
1.8.3 Mechanical Sector Scanner
1.8.4 Water-Path Scanner
1.9 Future Developments
References
2 Safety of Diagnostic Ultrasound
2.1 Primary Effects
2.1.1 Heat Production
2.1.2 Pseudocavitation and Microstreaming
2.1.3 Chemical Effects
2.2 Biologic Effects
2.2.1 Tissue Lesions and Ultrastructural Changes in Cells
2.2.2 Teratogenicity
2.2.3 Mutagenicity
2.2.4 Comutagenicity
2.2.5 Other Effects
2.3 The Problem of Safe Levels
2.4 Concluding Remarks
References
3 Examination of the Female Pelvis
3.1 General
3.1.1 Selection of Equipment
3.1.2 Examination Procedure
3.1.3 Findings
References
3.2 Pelvimetry
References
4 Pregnancy (First Trimester)
4.1 Normal Development
4.1.1 Definition of Terms, Basic Embryology
4.1.2 Earliest Detection of Intrauterine Pregnancy
4.1.3 Five Weeks: Morphology and Biometry of the Gestational Sac
4.1.4 Six Weeks: Embryonic Structures, Viability
4.1.5 Seven Weeks
4.1.6 Eight Weeks: Yolk Sac
4.1.7 Nine to Eleven Weeks: Biometry, Embryo fetal Structures
References
4.2 Abnormalities in the First Trimester
4.2.1 Blighted Ovum
4.2.2 Missed Abortion
4.2.3 Hydatidiform Mole
4.3 Ectopic Pregnancy
4.3.1 Detection of an Intact Intrauterine Pregnancy
4.3.2 Demonstration of an Intact Ectopic Pregnancy in the Cul-de-Sac or Adnexal Region
4.3.3 Complex Adnexal Masses
4.3.4 Fluid in the Abdomen or Cul-de-Sac
4.3.5 Principal Sources of Misdiagnosis in Patients with a Positive Pregnancy Test, No Visible Gestational Sac, and Suspected Ectopic Pregnancy
References
4.4 Tumors Associated with Pregnancy
References
4.5 The Kidney in Pregnancy
References
5 Multiple Pregnancy
References
6 Amniocentesis
References
7 Normal Fetal Anatomy in the Second and Third Trimesters
7.1 Examination Procedure
7.1.1 Face
7.1.2 Brain
7.1.3 Spine
7.1.4 Thorax
7.1.5 Abdomen
7.1.6 Urogenital Tract
7.1.7 Genitalia
7.1.8 Extremities
References
7.2 Ultrasound Biometry in the Second and Third Trimester
7.2.1 Introduction
7.2.2 Ultrasound Cephalometry
7.2.3 Fetal Trunk Measurements
7.2.4 Measurement of the Fetal Extremities
References
7.3 Diagnosis of Intrauterine Growth Retardation
7.3.1 Diagnostic Criteria, Possible Screening Methods
7.3.2 Technique and Accuracy of Measurement
References
7.4 Estimation of Fetal Weight
References
7.5 Critical Reading of the Biometry Literature
7.5.1 Importance of a Critical Approach
7.5.2 Why Fetal Biometry
7.5.3 How are Normal Values Derived
7.5.4 Selection of the Patients
7.5.5 Type of Studies: Cross-Sectional or Longitudinal
7.5.6 Sample Size
7.5.7 Study Design
7.5.8 Curve Fitting
7.5.9 What is the Basic Idea of Regression Analysis?
7.5.10 Linear Regression Analysis
7.5.11 Polynomial Regression Analysis
7.5.12 The Coefficients of Correlation and of Determination
7.5.13 The F Test
7.5.14 Prediction from Equations
7.5.15 How to Compute the Confidence Limits
7.5.16 Summary
References
7.6 Estimation of Gestational Age
7.6.1 Definitions
7.6.2 Parameters Proposed for Estimation of Gestational Age
7.6.3 Selection of Appropriate Table
7.6.4 What to Do When Different Parameters Provide Different Estimates
7.6.5 How to Report the Results
7.6.6 The Use of Computers for the Reporting of Obstetrical Examinations
References
7.7 Normal Growth of Fetal Parameters
7.7.1 Crown-Rump Length
7.7.2 Cranial Parameters
7.7.3 Thoracic and Abdominal Organs
7.7.4 Long Bones
7.7.5 Estimated Fetal Weight
References
8 Fetal Malformations
8.1 Signs Suggesting the Presence of a Malformation
References
8.2 Neural Tube Defects
8.2.1 Anencephaly
8.2.2 Spina Bifida
8.2.3 Encephalocele
References
8.3 Malformations of the Brain
8.3.1 Hydrocephalus
8.3.2 Microcephaly
References
8.4 Malformations Involving the Abdomen and Gastrointestinal Tract
8.4.1 Abdominal Wall Defects
8.4.2 Intraabdominal Structural Abnormalities
References
8.5 Malformations of the Urogenital Tract
8.5.1 Potter's Syndrome (Renal Agenesis)
8.5.2 Cystic Kidneys (Potter Type I)
8.5.3 Cystic Kidneys (Potter Type II)
8.5.4 Cystic Kidneys (Potter Type III)
8.5.5 Urinary Tract Obstruction
References
8.6 Skeletal Malformations
8.6.1 Radial Aplasia
8.6.2 Malformations Incompatible with Postnatal Viability
References
8.7 Tumors
8.7.1 Teratomas
8.7.2 Pulmonary Tumors
References
8.8 Heart Defects and Cardiovascular Diseases
8.8.1 Cardiovascular Disease
8.8.2 Heart Disease
References
8.9 Ultrasound Evaluation of Patients at Risk of Fetal Anomalies
8.9.1 High-Risk Group 1: Family History of Malformations
8.9.2 High-Risk Group 2: Exposure to Exogenous, Potentially Teratogenic Agents in Early Pregnancy
8.9.3 High-Risk Group 3: Maternal Diabetes Mellitus
8.9.4 High-Risk Group 4: Elevation of Serum or Amniotic Fluid AFP
References
9 Rhesus Incompatibility and Nonimmunologic Hydrops Fetalis
9.1 Rh Incompatibility
9.1.1 Definition and Pathogenetic Principle
9.1.2 Diagnosis and Management
References
9.2 Nonimmunologic Hydrops Fetalis
9.2.1 Etiology and Pathogenesis
9.2.2 Diagnosis and Treatment
References
10 Phenotype and Rare Syndromes
References
11 The Placenta
11.1 Sonographic Placental Development
11.2 Localization of the Placenta
11.3 Evaluation of Placental Growth
11.3.1 Placental Thickness
11.3.2 Placental Attachment Area, Surface Area, and Volume
11.4 Ultrasound Structure of the Placenta
References
12 The Cervix
References
13 Postpartum Ultrasound
References
14 Ultrasound Screening
14.1 The Multistage Concept
14.2 Ultrasound Anatomy
14.3 Diagnosis of Fetal Malformations
14.4 Determination of Gestational Age, Growth Monitoring, and Weight Assessment
14.4.1 Gestational Age
14.4.2 Growth Monitoring and Weight Assessment
References
14.5 Patterns of Fetal Activity and Their Relevance for the Assessment of Fetal Wellbeing
14.5.1 Patterns of Fetal Activity in Normal Pregnancy
14.5.2 Patterns of Fetal Activity in Complicated Pregnancy
14.5.3 Summary
References
14.6 The Psychological Impact of Ultrasound Scanning in Pregnancy
References
14.7 Conclusions
15 Sonographic Aspects of the Menstrual Cycle
15.1 Endometrium, Follicles, Blood Vessels
15.1.1 Endometrial Changes
15.1.2 Follicular Growth
15.1.3 Intrafollicular Structures
15.1.4 Bloodvessels
References
15.2 Applications of Ultrasound in Endocrinology
15.2.1 Monitoring of Gonadotropin Therapy
15.2.2 Monitoring of Clomiphene Citrate Therapy
15.2.3 Oocyte Collection for In Vitro Fertilization
15.2.4 Timing the Postcoital Test
15.2.5 Luteal Phase Defects
References
16 Pathology of the Genital Tract
16.1 Capabilities and Limitations of Sonographic Diagnosis
References
16.2 Applications of Ultrasound in Oncology
References
17 Intrauterine Contraceptive Devices
References
18 Diagnosis of Breast Disease
18.1 Normal Structures
18.2 Pathologic Structures
18.2.1 Duct Ectasia
18.2.2 Cysts
18.2.3 Acoustic Shadowing
18.2.4 Fibroadenomas
18.2.5 Carcinomas
18.2.6 Mastopathies
18.2.7 Mastitis
18.2.8 Implants
18.2.9 Gynecomastia
18.3 Real-Time Scans
18.4 Conclusions
References
19 Appendix
A Simple Reporting Program for Obstetrical Ultrasound.