Objectives

Objectives To present a systematic approach for evaluating the fetal pharynx and larynx based on twoand three-dimensional ultrasound (2D-US and 3D-US

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Although diagnostic ultrasonography is playing an increasing role in the investigation of the patient with suspected ectopic pregnancy (EP), it has significant limitations in the very early stages of pregnancy.By sonographically exploring the intrauterine echoes in 45 cases of documented EP, we demonstrated a unique pattern in 28 cases (62.2%). A well-defined spheric structure forming an endometrial three-layer (ETL) pattern was seen, probably formed by a midline echo between the two adjacent edematous proliferative layers of the endometrium, the latter resembling the late proliferative endometrium. The diagnosis of EP remains a clinical challenge for the gynecologist, despite improvements in diagnostic tests and procedures. There are a number of methods for establishing the presence of an EP: history, physical examination, biochemical tests, and imaging methods. These can all be used to diagnose EP as early as possible.The combination of serum P-HCG and vaginal ultrasonography has shown a high sensitivity and specificity for the diagnosis of ectopic pregnancy in several clinical studies:-' but despite these new technologies, the early diagnosis of EP in most cases is still a clinical challenge. In the past, the role of transabdominal (TA) ultrasonography of the pelvis was mainly t o exclude an intrauterine pregnancy and to identify fluid or blood in the pelvis.'^^ However, the transvaginal

Transvaginal ultrasonography-guided fetal reduction was performed in 11 patients presenting with multiple pregnancies. Embryonic aspiration was carried out in 7 women at 7 to 8 weeks and in 4 patients fetal intrathoracic injection was performed at 9 to 11 weeks, menstrual age. Seven patients delivered healthy babies at greater than 35 weeks, 3 have delivered prematurely 15 to 17 weeks after the procedure with subsequent neonatal death of all sets of twins. We believe that our method overcomes the technical difficulties related to the transabdominal or transcervical approach and should be the method of choice for early selective abortion.

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