Abstract: A torsional piezoelectric ultrasonic transducer design
is proposed to measure shear moduli in soft tissue with direct
access availability, using shear wave elastography technique. The
measurement of shear moduli of tissues is a challenging problem,
mainly derived from a) the difficulty of isolating a pure shear wave,
given the interference of multiple waves of different types (P, S,
even guided) emitted by the transducers and reflected in geometric
boundaries, and b) the highly attenuating nature of soft tissular
materials. An immediate application, overcoming these drawbacks,
is the measurement of changes in cervix stiffness to estimate the
gestational age at delivery. The design has been optimized using
a finite element model (FEM) and a semi-analytical estimator of
the probability of detection (POD) to determine a suitable geometry,
materials and generated waves. The technique is based on the time
of flight measurement between emitter and receiver, to infer shear
wave velocity. Current research is centered in prototype testing and
validation. The geometric optimization of the transducer was able
to annihilate the compressional wave emission, generating a quite
pure shear torsional wave. Currently, mechanical and electromagnetic
coupling between emitter and receiver signals are being the research
focus. Conclusions: the design overcomes the main described
problems. The almost pure shear torsional wave along with the short
time of flight avoids the possibility of multiple wave interference.
This short propagation distance reduce the effect of attenuation, and
allow the emission of very low energies assuring a good biological
security for human use.
Abstract: Background: Bleeding during first half of pregnancy
mostly originates from placenta, some abort, others are at risk of
complications. Objective: Study was done to know perinatal outcome
with bleeding up to 20 weeks in singleton pregnancy. Material
Methods: Subjects were 1020, equal controls managed over 2 years,
435 had viable pregnancy at admission, 135 excluded, 300 followed
for perinatal outcome, 99 (19.52% up to 10 weeks), 201 (39.18% of
11-20 weeks). Results: Hypertensive disorders occurred in 24% cases
of bleeding within 10 weeks, 22% 11-20 weeks 14.79% controls,
placenta previa 4% in 10 weeks, 0.9% 11-20 weeks, 0.97% controls,
prelabor rupture of membranes in 16%, 7.45% controls. 20% up to 10
weeks, 35% 11-20 weeks, 18% controls had fetal growth restriction,
34.34% up to 10 weeks 30.35% of 11-20 weeks 17.17% controls had
preterm births, perinatal mortality rate in study was 118.62, in
controls 68.16 (Uneventful pregnancy in 13.52% study, 46.11%
controls). Conclusion: Once bleeding occurs, one third continue
pregnancy, maternal neonatal outcome gets affected with variations
in cases of bleeding within first 10 weeks & 11-20 weeks.