Fourth Edition
Editors
Asim
Kurjak
MD PhD
Professor Emeritus Department of Obstetrics and Gynecology Medical School University of Zagreb President International Academy of Perinatal Medicine
Zagreb, Croatia
Frank A
Chervenak
MD PhD
Professor and Chairman Department of Obstetrics and Gynecology Weill Medical College of Cornell University/New York Presbyterian Hospital
New York, USA
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Donald School Textbook of Ultrasound in Obstetrics and Gynecology
First Edition: 2004
Second Edition: 2008
Third Edition: 2011
Fourth Edition:
2017
9789386056870
fm5
Dedicated to
Ian Donald
fm7
Contributors
-
Agnieszka Nocun
-
Gynecology and Oncology Clinic
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University Hospital in Krakow
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Krakow, Poland
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Aida Salihagic Kadic
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Professor
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Department of Physiology
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Medical School, University of Zagreb
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Zagreb, Croatia
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Ajlana Mulic-Lutvica
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Senior Consultant
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Department of Obstetrics and Gynecology
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Uppsala University Hospital
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Uppsala, Sweden
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Alaa Ebrashy
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Professor
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Department of Obstetrics and Gynecology
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Consultant in Fetal Medicine
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Cairo University
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Cairo, Egypt
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Aleksandar Ljubic
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Medigroup Hospital
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Belgrade, Serbia
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Dubrovnik International University
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Libertas, Dubrovnik, Croatia
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Alessandra Giocolano
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Department of Obstetrics and Gynecology
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III Obstetrics and Gynecology Unit
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University Medical School of Bari
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Bari, Italy
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Alexandra Matias
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Department of Obstetrics and Gynecology
-
Porto Medical Faculty of Medicine
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Hospital of S João
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Porto, Portugal
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Anna Maroto
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Hospital Universitari Vall d'Hebron
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Barcelona, Spain
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Antonella Cromi
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Department of Obstetrics and Gynecology
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University Medical School of Insubria
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Varese, Italy
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Aris J Antsaklis
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Professor of Obstetrics and Gynecology
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University of Athens
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Department of Maternal and
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Fetal Medicine
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Iaso Maternity Hospital
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Athens, Greece
-
Ashok Khurana
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The Ultrasound Lab
-
New Delhi, India
-
Asim Kurjak
-
Professor Emeritus
-
Department of Obstetrics and Gynecology
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Medical School University of Zagreb
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President
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International Academy of
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Perinatal Medicine
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Zagreb, Croatia
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Autumn Broady
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Division of Maternal-Fetal Medicine
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Department of Obstetrics, Gynecology and Women's Health
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John A Burns School of Medicine
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University of Hawaii
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Honolulu, Hawaii, USA
-
Berivoj Miskovic
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Department of Obstetrics and Gynecology
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Clinical Hospital Sveti Duh
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Zagreb, Croatia
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Biserka Funduk Kurjak
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Professor Emeritus
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Medical School University of Zagreb
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Zagreb, Croatia
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Carlota Rodo
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Hospital Universitari Vall d'Hebron
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Barcelona, Spain
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Carmina Comas Gabriel
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Fetal Medicine Unit
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Department of Obstetrics, Gynecology and Reproductive Medicine
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University Hospital Quiron Dexeus
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Barcelona, Spain
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Cihat Şen
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Professor
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Department of Perinatal Medicine
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Cerrahpasa Medical School
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University of Istanbul and Perinatal Medicine Foundation
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Istanbul, Turkey
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Eberhard Merz
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Professor
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Center for Ultrasound and Prenatal Medicine
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Krankenhaus Nordwest
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Frankfurt/Main, Germany
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Edoardo Di Naro
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Associate Professor
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I Obstetrics and Gynecology Unit
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University Medical School of Bari
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Bari, Italy
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Elena Carreras
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Hospital Universitari Vall d'Hebron
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Barcelona, Spain
-
Eva Meler Barrabés
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I+D+i Obstetric Clinic
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Department of Obstetrics, Gynecology and Reproductive Medicine
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University Hospital Quirón Dexeus
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Barcelona, Spain
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Professor
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Department of Obstetrics and Gynecology
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University of Valencia, School of Medicine
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Valencia, Spain
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Francesc Figueras
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Service of Fetal Medicine
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Clinical Institute of Gynecology, Obstetrics and Neonatology
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University of Barcelona
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Barcelona, Spain
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Francisco Bonilla Jr
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Department of Obstetrics and Gynecology
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University of Valencia, School of Medicine
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Valencia, Spain
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Francisco Raga
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Department of Obstetrics and Gynecology
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University of Valencia, School of Medicine
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Valencia, Spain
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Frank A Chervenak
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Professor and Chairman
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Department of Obstetrics and Gynecology
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Weill Medical College of Cornell University/New York Presbyterian Hospital
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New York, USA
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Frederico Rocha
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Division of Maternal Fetal Medicine
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Department of Obstetrics, Gynecology and Women's Health
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John A Burns School of Medicine University of Hawaii
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Honolulu, Hawaii, USA
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Gabriella Minneci
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Department of Obstetrics and Gynecology
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AOUP Paolo Giaccone
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Palermo, Italy
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Geeta Sharma
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Weill Medical College, Cornell University
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New York, USA
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George A Partsinevelos
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1st Department of Obstetrics and Gynecology
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Alexandra Hospital
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University of Athens
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Athens, Greece
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Giovanni Centini
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Foundation President
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“Danilo Nannini” for Motherhood and Childhood
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Santa Maria alle Scotte Hospital
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Siena, Italy
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Giuseppe Cali
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Department of Obstetrics and Gynecology
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Maternal Fetal Medicine Unit
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ARNAS Civico Hospital
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Palermo, Italy
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Grazia Volpe
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Fetal Medicine Unit
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Department of Obstetrics and Gynecology
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Medical School, University of Bari
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Bari, Italy
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Ivica Zalud
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Professor and Chair
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Kosasa Endowed Chair
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Department of Obstetrics, Gynecology and Women's Health
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John A Burns School of Medicine
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University of Hawaii
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Honolulu, Hawaii, USA
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Jiri Sonek
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Department of Obstetrics and Gynecology
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Wright State University
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President
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Fetal Medicine Foundation of the United States of America
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Dayton, Ohio, USA
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Jon Hyett
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High Risk Obstetrics
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RPA Women and Babies
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Royal Prince Alfred Hospital
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Central Clinical School, University of Sydney
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Sydney, Australia
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José M Carrera
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President
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Matres Mundi
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Barcelona, Spain
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Juan Carlos Castillo
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Department of Obstetrics and Gynecology
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University of Valencia, School of Medicine
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Valencia, Spain
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Juan Luis Alcázar
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Department of Obstetrics and Gynecology
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University Clinic of Navarra
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School of Medicine, University of Navarra
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Pamplona, Spain
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Judith L Chervenak
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Department of Obstetrics and Gynecology
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New York University School of Medicine
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New York, USA
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Jure Knez
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Department of Reproductive Medicine and Gynecologic Endocrinology
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Maribor University Medical Centre
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Maribor, Slovenia
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Kazunori Baba
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Professor
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Center for Maternal, Fetal and Neonatal Medicine
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Saitama Medical Center, Saitama Medical University
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Saitama, Japan
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Kazuo Maeda
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Professor Emeritus
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Department of Obstetrics and Gynecology
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Tottori University Medical School
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Yonago, Japan
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Kohei Shiota
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Department of Anatomy and Developmental Biology
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Congenital Anomaly Research Center
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Kyoto University Graduate School of Medicine
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Kyoto, Japan
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Lucia Rosignoli
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Prenatal Diagnosis Unit
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University Hospital Meyer
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Florence, Italy
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Luigi Raio
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Department of Obstetrics and Gynecology
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University of Bern
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Bern, Switzerland
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Maja Predojevic
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Department of Obstetrics and Gynecology
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Medical School, University of Zagreb
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Clinical Hospital “Sveti Duh”
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Zagreb, Croatia
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Marcin Wiechec
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Consultant, Fetal Anomalies and Ultrasound
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Coordinator, Interclinical Ultrasound Lab
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Chair, Gynecology and Obstetrics
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Jagiellonian University in Krakow
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Krakow, Poland
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Professor
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Department of Obstetrics and Gynecology
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Medical School University of Zagreb
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Neonatal Unit
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University Hospital Sveti Duh
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Zagreb, Croatia
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Mohamed Ahmed Mostafa AboEllail
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Department of Perinatology and Gynecology
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Kagawa University Graduate School of Medicine
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Ikenobe, Miki, Kagawa, Japan
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Narendra Malhotra
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Malhotra Nursing and
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Maternity Home (P) Ltd
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Agra, Uttar Pradesh, India
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Neharika Malhotra Bora
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Malhotra Nursing and
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Maternity Home (P) Ltd
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Agra, Uttar Pradesh, India
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Nuno Montenegro
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Porto Medical Faculty of Medicine
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Department of Obstetrics and Gynecology
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Hospital of S João
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Porto, Portugal
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Oliver Vasilj
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Department of Obstetrics and Gynecology
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Clinical Hospital Sveti Duh
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Zagreb, Croatia
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Oscar Caballero
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Department of Obstetrics and Gynecology
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University of Valencia, School of Medicine
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Valencia, Spain
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Panagiotis Antsaklis
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1st Department of Obstetrics and Gynecology
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Alexandra Maternity Hospital
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University of Athens
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Athens, Greece
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Ritsuko Kimata Pooh
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Clinical Research Institute of Fetal Medicine and Perinatal Medicine Clinic
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Osaka, Japan
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Robin B Kalish
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Division of Maternal-Fetal Medicine
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Department of Obstetrics and Gynecology
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Weill Medical College of Cornell University
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New York, USA
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Sanja Kupesic Plavsic
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Department of Obstetrics and Gynecology
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Paul L Foster School of Medicine
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Texas Tech University Health Sciences Center
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El Paso, Texas, USA
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Selma Porovic
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Department of Pediatric Dentistry
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Public Health Center of the Sarajevo Canton
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Sarajevo, Bosnia and Herzegovina
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Sonal Panchal
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Dr Nagori's Institute for Infertility and IVF
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Ahmedabad, Gujarat, India
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Sonila Pashaj
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Department of Obstetrics and Gynecology
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University Hospital “Koco Gliozheni”
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Tirana, Albania
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Stephen T Chasen
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Weill Medical College of Cornell University
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New York, USA
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Tamara Illescas
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Hospital Universitari Vall d'Hebron
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Barcelona, Spain
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Delta Ultrasound Diagnostic Center in Obstetrics and Gynecology
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Madrid, Spain
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Tatjana Bozanovic
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School of Medicine, Belgrade University
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Institute for Obstetrics and Gynecology, Clinical Center of Serbia
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Belgrade, Serbia
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Toshiyuki Hata
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Department of Perinatology and Gynecology
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Kagawa University Graduate School of Medicine
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Ikenobe, Miki, Kagawa, Japan
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Tuangsit Wataganara
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Associate Professor
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Division of Maternal-Fetal Medicine
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Department of Obstetrics and Gynecology
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Faculty of Medicine Siriraj Hospital
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Bangkok, Thailand
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Ulrich Honemeyer
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Department of Obstetrics, Gynecology and Fetal-Maternal Medicine
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Alzahra Hospital
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Dubai, United Arab Emirates
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Veljko Vlaisavljevic
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Department of Reproductive Medicine and Gynecologic Endocrinology
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University Medical Center Maribor
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Maribor, Slovenia
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Vincenzo D'Addario
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Fetal Medicine Unit
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Department of Obstetrics and Gynecology
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Medical School, University of Bari
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Bari, Italy
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Waldo Sepulveda
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Professor
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Director, Fetalmed – Maternal-Fetal Diagnostic Center
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University of Santiago de Chile (USACH)
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Santiago, Chile
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William Goh
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Clinical Instructor
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Department of Obstetrics, Gynecology and Women's Health
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John A Burns School of Medicine
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University of Hawaii at Manoa
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Honolulu, Hawaii, USA
-
Zoltán Papp
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Professor
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Maternity Private Clinic
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Semmelweis University
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Budapest, Hungary
-
Zoltán Tóth
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Department of Obstetrics and Gynecology
-
Debrecen University
-
Debrecen, Hungary
The Ian Donald International School of Ultrasound bears testament to globalization in its most successful and worthwhile form. The school was founded in Dubrovnik in 1981; in the preface of the first edition in 2004 we were proud to announce that the School had grown to 8 branches. Since then, the growth has been meteoric and now consists of 112 branches in almost every corner of the globe. The reason for this success has been the tireless and selfless efforts of the world's leading authorities in ultrasound who are willing to dedicate their valuable time without reimbursement to teach sonologists and sonographers throughout the world. Our teachers put national, religious, political, and other parochial considerations aside as they strive to improve the care of all women and fetal patients. Politicians in the countries represented by our School have much to learn from the purity of spirit that exists throughout our international family. We believe that Ian Donald is smiling down from heaven at the School that bears his name.
In the educational efforts of the 112 branches of the Ian Donald School, there is clearly a need for a textbook to complement and supplement lectures and didactic sessions. The first, second and the third textbooks were successful in this endeavor, but with the explosion of knowledge, it was clear that an expanded and updated fourth edition would be invaluable. The current edition of our textbook illustrates the latest developments including silhouette ultrasound and four-dimensional ultrasound which have been pioneered by our school. For the sake of simplicity, our book is divided into three sections. Section one deals with a variety of topics that lay the foundation for the rest of the book. Section two addresses the myriad subtopics in obstetric ultrasound that optimize the care of pregnant women and fetal patients. The last section addresses the essential role that ultrasound plays in the many dimensions of clinical gynecology.
A special word of thanks to Jadranka, our tireless secretary for her hundreds of dedicated hours of quality work.
We are grateful to many course directors and lecturers of the Ian Donald School who have enabled its growth and have selflessly contributed to this volume. In order to maximize the reach of this textbook by minimizing its price, all contributors have waived any honorarium or royalty. Their dedication to the dream of globalized quality ultrasound has enabled its reality.
Asim Kurjak
Frank A Chervenak
fm12
fm13Preface to the First Edition
Ultrasound is the backbone of modern obstetric and gynecology practice. For those of us old enough to remember the dark ages of clinical practice prior to ultrasound, this is not an overstatement. Younger physicians may find it hard to imagine the clinical realities of doctors who delivered undiagnosed twins presenting at delivery, who performed unnecessary surgeries for the clinical suspicion of a pelvic mass that was not present, and who consoled anguished parents when an anomalous infant was born unexpectedly. Recent technological breakthroughs in diagnostic ultrasound, including the advent of color Doppler, power Doppler, three-dimensional and four-dimensional imaging, have led ultrasound to surpass the expectations of Ian Donald, its visionary father.
The Ian Donald School was founded in 1981 and is devoted to international education and research cooperation concerning all aspects of diagnostic ultrasound. The first chapter was founded in Dubrovnik at that time and has now expanded to 7 additional national branches.
To facilitate the educational efforts of the Ian Donald School, we believed a textbook would be of value. The text is divided into three parts general aspects, obstetrics, and gynecology. All contributors are either present or former teachers in the 8 branches of the Ian Donald School. We believe this comprehensive text with state-of-the-art images will be of value for both new learners and experienced practitioners.
We are grateful to all of the teachers in the School and especially to all of the contributors to this textbook for their tireless efforts to enhance the quality of ultrasound practice throughout the world.
Asim Kurjak
Frank A Chervenak