Ultrasound plays an integral part in the diagnosis and management of many gynaecological conditions; indeed, ultrasound forms part of the RCOG's mandatory training programme for doctors wishing to specialise in obstetrics and gynaecology. This book will be of use to both trainees and those already in clinical practice looking for a user-friendly reference guide. The use of ultrasound in gynaecology goes well beyond simple picture recognition: a skilful gynaecological sonographer will bring together scan findings and the clinical scenario to enhance patient care. This leads to targeted investigations and strategies for intervention. This book covers all aspects of the use of ultrasound in the fields of gynaecology and early pregnancy, with the contents including: postmenopausal bleeding; adnexal masses; pelvic pain; reproductive medicine; miscarriage; ectopic pregnancy; and ovarian cysts.

Since the pioneering work of Donald and his first Lancet paper in 1958, the use of ultrasound in obstetrics and gynaecology has evolved rap idly. The introduction of grey scale techniques enhanced our ability to identify different tissues on the basis of their texture. However, it was the introduction of the linear array real-time scanner in the mid seven ties that changed ultrasound from being an "eccentric art form" to a readily available and usable technique. This led to the first reports of the diagnosis of neural tube defects using ultrasound by Campbell, as well as the establishment of fetal biometry. In the midst of this activity the parallel development of the transvaginal probe by Kratochwill went almost unnoticed by most gynaecologists. Yet the application of this technique has since had a major impact on many areas of gyna ecological practice, and on infertility in particular. Since the demon stration of transvaginal follicle aspiration, the vaginal route has become standard for most invasive ultrasound guided gynaecological procedures. The relatively new technical advance of transvaginal colour Doppler may potentially have just as great an impact. The introduction and use of transvaginal colour flow imaging has facili tated the study of vascular changes within the pelvis.

Acute gynaecological problems are among the most common reasons for women of reproductive age to seek medical help. Emergency outpatient visits now outnumber elective clinical appointments in gynaecology. With a growing number of patients, increasingly complex diagnostic algorithms and a wide range of management options, the participation and training of senior doctors in this field is vital to ensure women receive the best possible treatment. This book provides a thorough overview of acute gynaecology and early pregnancy and has been designed to reflect the syllabus of the RCOG's Advanced Training Skills Module (ATSM) in 'Early pregnancy and emergency gynaecology'. It covers the diagnosis and management of routine clinical problems, such as miscarriage and tubal pregnancy, as well as less frequently seen presentations, such as uncommon forms of ectopic pregnancy and trophoblastic disease. The use of drugs in early pregnancy and management organisational aspects of care are also addressed.