Determination of the Volume of Early Hypotonic Hemorrhage by 3D Modeling of Ultrasound Investigation Results
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Determination of the Volume of Early Hypotonic Hemorrhage by 3D Modeling of Ultrasound Investigation Results A. M. Ziganshin1, V. A. Mudrov2*, and A. K. Lyapunov2
An original method for determining the volume of early hypotonic hemorrhage is presented. The method is based on clinical application of 3D modeling of results obtained by ultrasound investigations of the uterine cavity and gravimetric assessment of the volume of external blood loss. A scheme for computation is described, a method for 3D modeling of the postpartum uterus is created, and the effectiveness of using this method for determining the volume of hemorrhage is assessed.
Introduction Obstetric bleeding is currently the most frequent cause of maternal mortality. The volume and severity of blood loss are assessed by visual evaluation, the gravimet ric method, and clinical interpretation of the symptoms of hypovolemia [1]. The visual method underestimates the blood loss volume (BLV) by an average of 30% because of its subjectivity. The errors of the visual method increase with increasing BLV, so clinical practice must be oriented to the general state of the patient. The gravimet ric method is based on direct collection of lost blood in a graduated vessel (collection bags, cylinders, or Cell Saver systems), and by weighing bloodsoaked bandages and surgical garb. This method is more accurate (about 90%) than the visual approach, though it too does not give accurate data on actual BLV [1]. This leads to the need for dynamic evaluation of uterine cavity volume (UCV) dur ing the early postpartum period, along with assessment of the volume of external bleeding by the gravimetric method. Undoubtedly, the most significant methods for assessment of organ volume are computed tomography (CT) and magnetic resonance imaging (MRI) [2]. How 1
Bashkir State Medical University, Ministry of Heath of the Russian Federation, Ufa, Russia. 2 Chita State Medical Academy, Ministry of Heath of the Russian Federation, Chita, Russia; Email: [email protected] * To whom correspondence should be addressed.
ever, MRI and CT scans cannot be used in routine prac tice because of the large distance between the birth room and the investigation facilities, as well as the high cost of these investigations. The volume of an organ cavity is conventionally calculated using formulas created for reg ular geometrical shapes (ellipses) and based on two dimensional ultrasound scans. Wide use is currently made of threedimensional ultrasonography, which is a more accurate method for assessing the volumes of organs and cavities with uneven surface contours than twodimen sional methods [2]. However, threedimensional ultra sound imaging in the conditions of a regional hospital is not as widely available as conventional twodimensional scanning. Casikar et al. described a solution to this problem in the form of 3D modeling, allowing a virtual model of the uterine body to be constructed with automatic computa tion of its volume. The virtual model was built on the basis of tracing
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