241 Fetal Imaging Workstation
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344 SPO Abstracts 241 FETAL IMAGING WORKSTATION. W. Lee*. C.H. Comstock*. J.S. Kirk. Div of Fetal Imaging. William Beaumont Hospital. Royal Oak. MI; Wayne State University * An interactive fetal imaging computer workstation has been established (William Beaumont Hospital Research Institute. March of Dimes Birth Defects Foundation. Apple Computer) to examine various ways that images and sophisticated computer graphics can be used to interactively teach physicians about the prenatal diagnosis of birth defects. Main features include: I) fetal ultrasound image and animation library; 2) medical image archival system; 3) data-base categorization and image search capabilities; 4) interactive multimedia tutorials; and 5) in-house slide production. This system uses a Macintosh IIfx computer with a 19 inch Superrnac monitor. Ultrasound images arc typically captured from videotape (Nuvista card. FORA color encoder. FORA time-based corrector) or photographs (Sharp JX-600 scanner). Correlative autopsy specimens arc either digitized from standard photographs or by an electronic still camera system (Sony ProMavica). These images arc postprocessed through Adobe Photoshop and digitally archived onto optical disk. Processed images can be placed onto hard disk. laserdisc (Panasonic TQ-3031 F). or CD-ROM for inclusion into a variety of educational tutorials via Macromind Director. A Supercard application provides clinical database organization and search capabilities for up to 108.000 images on a 12-inch laserdisc. We are currently in the process of developing interactive multimedia software interfaces for the fetal imaging library. Photorealistic 3-D animation software will be eventually used to simulate normal and abnormal fetal heart development. Our works-in-progress demonstration will show potential uses for this visually-based information management system. 242 CUSTOMISED ANTENATAL GROWTH CHARTS J Gardosi x , A Chang x, B Kalyan x, EM Symonds x Perinatal Research & Monitoring Unit, Dept Ob/Gyn Queens Medical Centre, Nottingham, Enl(\and A new antenatal chart was developed which can be 'customised' to each mother's individual characteristics and used to assess birth centiles of her previous babies, as well as fundal measurements and ultrasou'!d - estimat.ed fetal dunng the ongoing pregnancy. Multtple regressIOn and vanance analysis was performed on computerised dat.a from 4179 pregnancies with ultrasound-confirmed dates. ThIS .that m addition to gestation and sex, the maternal bookmg weIght, height, ethnic group and parity were determinants of blrthweight m our populatIOn. Correctton factors were calculated and entered into a computer programme which uses this to a growth chart with corrected centIle curves. ThIS can be pnnted out at the beginning of pregnancy and added to the notes. adjustment of normal limits resulted,. in our retrospecl!ve sample, in a reduction of falsc-\?oslttvc and false-ne.gattve diagnoses of 'SGA' (small for gestatIOnal age; < 10th centtle) by 28% and 24%, and 'LGA' (large for gestational age; >90th centilc) by 22% and 26%, respectively. We suggest .that the relevant physiological variables which act as of birthweight in a particular maternity populatton need tf! be better recognised in clinical practice. Prospective analYSIS IS planned, and we hypothesize that such 'customisati<:m' of assessment will reduce unnecessary mvestIgatlOns, mterventIons and patient anxiety and lead to better allocation of existing resources. January 1992 Am.J Obstet Gynecol 243 A COMPREHENSIVE PERINATAL DATABASE PROGRAM. P. UrSQ.X J.A. L6pez-ZenQ,x B. Nies,X S. Bathgate,X J. GrQssman. Dept. Qf OB-GYN, The GeQrge WashlngtQn UniversIty MedIcal SchQQI. WashlngtQn, D.C. Using a relational database program (OMNIS) we have designed a comprehensive perinatal database. It is capable of storing all the information that is requested in the ACOG Prenatal Forms This includes all data from prenatal visits, including laboratory test results. In addition, it is capable of storing and generating fetal surveillance reports, like NST, CST or BPP. Calculations of gestational age and fetal weight are incorporated into the ultrasound reports generated by this database. Upon admission to labor and delivery, all outpatient information is available in a computer terminal. The physician'S admission, delivery and discharge notes can be computer generated with the information collected during labor and delivery. Nursing notes and birth certificates are also incorporated into the database. Our system provides a single, unified data resource capable of meeting both research and quality assurance needs. At our institution, the peer review process is currently conducted with information primarily obtained from this database, which conforms to the JCAH obstetrical standards. It also generates resident's experience forms and attending's case list for the ABOG. We are currently integrating the obstetrical anesthesia and neonatal data into this program. This program can be utilized in the Macintosh or the IBM operative systems. A demonstration of the Macintosh version will be given at the SPO meeting.
Transcript of 241 Fetal Imaging Workstation
344 SPO Abstracts
241 FETAL IMAGING WORKSTATION. W. Lee*. C.H. Comstock*. J.S. Kirk. Div of Fetal Imaging. William Beaumont Hospital. Royal Oak. MI; Wayne State University *
An interactive fetal imaging computer workstation has been established (William Beaumont Hospital Research Institute. March of Dimes Birth Defects Foundation. Apple Computer) to examine various ways that images and sophisticated computer graphics can be used to interactively teach physicians about the prenatal diagnosis of birth defects. Main features include: I) fetal ultrasound image and animation library; 2) medical image archival system; 3) data-base categorization and image search capabilities; 4) interactive multimedia tutorials; and 5) in-house slide production. This system uses a Macintosh IIfx computer with a 19 inch Superrnac monitor. Ultrasound images arc typically captured from videotape (Nuvista card. FORA color encoder. FORA time-based corrector) or photographs (Sharp JX-600 scanner). Correlative autopsy specimens arc either digitized from standard photographs or by an electronic still camera system (Sony ProMavica). These images arc postprocessed through Adobe Photoshop and digitally archived onto optical disk. Processed images can be placed onto hard disk. laserdisc (Panasonic TQ-3031 F). or CD-ROM for inclusion into a variety of educational tutorials via Macromind Director. A Supercard application provides clinical database organization and search capabilities for up to 108.000 images on a 12-inch laserdisc. We are currently in the process of developing interactive multimedia software interfaces for the fetal imaging library. Photorealistic 3-D animation software will be eventually used to simulate normal and abnormal fetal heart development. Our works-in-progress demonstration will show potential uses for this visually-based information management system.
242 CUSTOMISED ANTENATAL GROWTH CHARTS J Gardosi x , A Chang x, B Kalyan x, EM Symonds x
Perinatal Research & Monitoring Unit, Dept Ob/Gyn Queens Medical Centre, Nottingham, Enl(\and
A new antenatal chart was developed which can be 'customised' to each mother's individual characteristics and used to assess birth centiles of her previous babies, as well as fundal hei~ht measurements and ultrasou'!d - estimat.ed fetal w~ights dunng the ongoing pregnancy. Multtple regressIOn and vanance analysis was performed on computerised dat.a from 4179 pregnancies with ultrasound-confirmed dates. ThIS s~owed .that m addition to gestation and sex, the maternal bookmg weIght, height, ethnic group and parity were significa~t, independ~nt determinants of blrthweight m our populatIOn. Correctton factors were calculated and entered into a computer programme which uses this data~ase to genera~e a person~lised growth chart with corrected centIle curves. ThIS can be pnnted out at the beginning of pregnancy and added to the notes. S~ch adjustment of normal limits resulted,. in our retrospecl!ve sample, in a reduction of falsc-\?oslttvc and false-ne.gattve diagnoses of 'SGA' (small for gestatIOnal age; < 10th centtle) by 28% and 24%, and 'LGA' (large for gestational age; >90th centilc) by 22% and 26%, respectively. We suggest .that the relevant physiological variables which act as ~etermmants of birthweight in a particular maternity populatton need tf! be better recognised in clinical practice. Prospective analYSIS IS planned, and we hypothesize that such 'customisati<:m' of gr~wth assessment will reduce unnecessary mvestIgatlOns, mterventIons and patient anxiety and lead to better allocation of existing resources.
January 1992 Am.J Obstet Gynecol
243 A COMPREHENSIVE PERINATAL DATABASE PROGRAM. P. UrSQ.X J.A. L6pez-ZenQ,x B. Nies,X S. Bathgate,X J. GrQssman. Dept. Qf OB-GYN, The GeQrge WashlngtQn UniversIty MedIcal SchQQI. WashlngtQn, D.C.
Using a relational database program (OMNIS) we have designed a comprehensive perinatal database. It is capable of storing all the information that is requested in the ACOG Prenatal Forms This includes all data from prenatal visits, including laboratory test results. In addition, it is capable of storing and generating fetal surveillance reports, like NST, CST or BPP. Calculations of gestational age and fetal weight are incorporated into the ultrasound reports generated by this database. Upon admission to labor and delivery, all outpatient information is available in a computer terminal. The physician'S admission, delivery and discharge notes can be computer generated with the information collected during labor and delivery. Nursing notes and birth certificates are also incorporated into the database. Our system provides a single, unified data resource capable of meeting both research and quality assurance needs. At our institution, the peer review process is currently conducted with information primarily obtained from this database, which conforms to the JCAH obstetrical standards. It also generates resident's experience forms and attending's case list for the ABOG. We are currently integrating the obstetrical anesthesia and neonatal data into this program. This program can be utilized in the Macintosh or the IBM operative systems. A demonstration of the Macintosh version will be given at the SPO meeting.
