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by Dr. Donald L. King The past decade has seen the ascent of ultrasonography to a preeminent position as a diagnostic imaging modality for obstetrics and gynecology. It can be stated without qualification that modern obstetrics and gynecology cannot be practiced without the use of diagnostic ultrasound, and in particular, the use of ultrasonogra­ phy. Ultrasonography quickly and safely provides detailed, high­ resolution images of the pelvic organs and gravid uterus. The quality and quantity of diagnostic information obtained by ultra­ sonography far exceeds anything previously available and has had a revolutionary impact on the management of patients. High­ resolution static images permit the intrauterine diagnosis of fetal growth retardation and fetal abnormalities. In addition to tradi­ tional images, newer dynamic imaging techniques allow observa­ tion of fetal motion, cardiac pulsation, and respiratory efforts. The use of ultrasonography for guidance has greatly augmented the safety and utility of amniocentesis. One of the great virtues of diagnostic ultrasound has been its apparent safety. At present energy levels, diagnostic ultrasound appears to be without any injurious effect. Although all the availa­ ble evidence suggests that it is a very safe modality and that the benefit to risk ratio is very high, the actual safety margin for its use Vll as yet remains unknown. As a consequence, practitioners are urged to limit its use only to those situations in which genuine clinical indica­ tions exist and real benefit to the patient is likely to result.

by Dr. Jan. J. Smulewicz Ultrasound imaging has reached a stage of sophistication where­ by diagnostic information can be gained without discomfort to the patient and with complete absence of morbidity and mortality. The procedure is quick, safe, noninvasive and in many instances can supersede and obviate more time-consuming procedures requiring catheterization, injection of a contrast material, and radiographic imaging. In obstetrical problems the danger of ionizing radiation to the fetus is eliminated. In debilitated and very ill patients this simple and painless method becomes the procedure of choice. Unique features of ultrasound equipment allow for pinpoint local­ ization oflesions and direct visual guidance of percutaneous puncture techniques for aspiration and biopsy. The accuracy of ultrasound guided punctures and the absence of side effects make this modality far superior to percutaneous invasive techniques performed with other imaging systems. Renal cyst puncture and amniocentesis are but two of the procedures in which ultrasonic guidance is the method of choice. v Dr. Hassani has throughly explained and carefully explored the wide variety of exam­ inations available with ultrasound. The large volume of material and the clear interpre- tion makes this book of great interest to all of the medical profession. In addition to the existing methods available for diagnostic in­ terpretations, this method of noninvasive diagnosis should find its way into every hospital or center where good medical care is provided. JanJ. Smulewicz, M.D.