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Two small series of cases documenting ultrasound misdiagnoses are presented. The first concerns obstetric ultrasound misdiagnoses originating in the private offices of physicians. The second concerns gynecologic ultrasound misdiagnoses originating in a level II medical center. A dichotomy exists in the use of diagnostic ultrasound examination in the practice of obstetrics and gynecology. The dichotomy is a serious defect in our specialty that needs urgent addressing. The institutional problem can be partially resolved by furnishing the sonographer with the referred patient's history and physical findings. The problem of the ultrasound machine in the office of a private physician is much more complex. It may require government intervention and strict licensing measures for resolution.

Over a 10-year period 12,643 gynecologic surgical procedures were performed with the patients under general anesthesia. Succinylcholine was the muscle relaxant used in the majority of cases. Four of these patients developed prolonged postoperative apnea; the longest period of apnea was 6 hours. In one patient atypical cholinesterase was documented, and two of the patients were subsequently diagnosed as having myasthenia gravis. In the fourth case an etiology for the apnea was not demonstrated. A compilation of drugs in common clinical usage which interfere with neuromuscular transmission is included.

A review of 300 cases of breast cancer in a community hospital was undertaken to document who made the initial discovery of the breast lesion. In this series, the woman discovered her own cancer in 75% of the cases. Obstetrician-gynecologists, who made up only 8% of the medical staff, discovered almost one third of the primary lesions that were first noticed by physicians. Obstetrician-gynecologists were the first physicians consulted by 20% of the women who discovered their own breast lesions. Preoperative xeromammography was performed on 58% of the patients with breast cancer, and there was a false negative report in 21% of these patients.