January 1, 1998

For media inquiries, contact:
Roberta F. Speyer
President and CEO
Elecomm Corporation
5707 Lakemoore Drive, Suite 100
(512) 231-0810
roberta.speyer@obgyn.net

TURNING SHADOWS INTO SUBSTANCE: OBGYN.net LAUCHES ULTRASOUND SECTION

Austin, Tex. -- OBGYN.net, the leading Web site for information about women's health issues, has unveiled a new section devoted to advances in ultrasound technology.

Roberta Speyer, president and CEO of OBGYN.net, says the site is primarily intended for use by medical professionals involved in the use of ultrasound in the fields of obstetrics and gynecology. But, she adds, patients and families also will benefit from access to a range of information about this increasingly important medical technology. According to Speyer, "The goal of the new section is to bring all the Internet resources available on the topic into one convenient and easy-to-use site."

The need for fast access to ultrasound information that takes advantage of the visual capabilities of the Web was dramatically demonstrated earlier this year. A physician in Croatia had conducted an ultrasound scan on a twenty-year-old woman who was eighteen weeks pregnant. The shadows he saw on the screen concerned him. There appeared to be a band of scar-like tissue across the amniotic sac. Such bands can constrict fetal growth, resulting in a baby born with severely deformed - possibly even amputated - arms or legs.

He needed more information, but none of his nearby colleagues had the expertise necessary to help him make sense of what he saw. By searching the Internet, he discovered the email list maintained by OBGYN.net. His email message describing the patient's history and the scans caught the attention of Terry DuBose, a sonographer located a quarter of the globe away in Little Rock, Arkansas.

"I suggested that he digitize the images and send them to us electronically," said DuBose, who is director of the Diagnostic Medical Sonography Program at the University of Arkansas for Medical Sciences and a correspondent for OBGYN.net. When the scans arrived, DuBose posted them on Web and notified the subscribers of the OBGYN mailing list to drop by and take a look.

Soon feedback was whizzing in from the far corners of the Web community, including Asia and New Zealand. Some who commented noted the fact that the patient had had a previous abortion involving dilation and curettage. As a result, the consensus soon emerged that the mysterious shadows probably represented an erosion in part of the lining of the uterus, a condition known as synechia (or Asherman syndrome). Synechia is a much less threatening condition than amniotic bands, and the outlook for the woman and her baby was good.

The Croatian physician was overwhelmed by the response. As he put it, "I'm sitting in my living room looking at my images on the Web and getting opinions from all over the world. I can't believe my eyes."

The ultrasound section of OBGYN.net is sponsored by Siemens, among the world's largest technology and communications companies. Recently Siemens introduced the SieScape™ Imaging system, an innovative ultrasound device that allows health care professionals a wider field of view of the organs and tissues of body.

In the early days of ultrasound, the technology involved an "articulated arm" - a maneuverable device that allowed the sonographer to create an image of a large part of the body. The operator would move the arm back and forth over the area. Each pass of the transducer attached to the arm would generate a single line of image on the monitor. In a way, the process was similar to that involved in making a tracing or a brass rubbing.

According to Doug Whisler, Siemens' Senior Market Manager for Women's Healthcare, this method allowed a large field of view, but it did not generate a real-time image. As a result, it was not possible to detect fetal movement, and changes in the anatomy being studied were not easy to see. The SieScape system takes advantage of today's high-speed computer processors to analyze the massive amounts of data and generate larger images. "This advance was not possible even a few years ago," says Whisler.

In the field of obstetrics, the SieScape Imaging system's main role will be in the second and third trimesters. The extended view allows operators a better image of the general orientation of fetus, the position of the uterus, and the amount of amniotic fluid present.

According to Roberta Speyer, the new ultrasound Web site offers many of the features that have made the other areas of the OBGYN.net site such a popular center for the online women's health community. For example, there is an email list and a discussion forum devoted exclusively to ultrasound topics. Subscribers to the list receive and exchange messages instantly, while visitors to the forum can browse the archives and zero in on discussions of particular interest.

The site will publish news reports, original articles, and selected publications and abstracts from medical journals and other sources. Before such items are posted on the site, they are reviewed by an advisory panel of medical professionals. Terry DuBose, chairman of the panel, notes that members are recruited both for their expertise in ultrasonography and for their interest in using the Web as a means of communicating with their colleagues around the world.

The ultrasound section will include a large collection of hyperlinks to other ultrasound sites on the Web. Prior to its listing, each of these sites is visited and reviewed by the OBGYN.net staff to make sure that the content is medically sound and of value to the community.

The section will be home to a growing archive of ultrasound images. As is the case with other sections of OBGYN.net, the ultrasound section will be accessible to anyone who visits the site. However, the content will be tailored primarily for physicians, sonographers, and other medical professionals. "The images available might involve a tricky case, or an uncommon lesion, something you see only once in your career," states David Ashley Hill, M.D., an Ob/Gyn from Orlando, Florida, and a member of the site's advisory panel.

Another advisor, Joseph Woo, M.D., an Ob/Gyn with a private practice in Hong Kong, welcomes the opportunity to discuss specific ultrasound findings with colleagues around the globe. "For example," he commented in a recent interview by email, "we might be invited to talk about the significance of mild ventriculomegaly (12 mm at the trigone) at 24 weeks."

Each month, the ultrasound section will present an interactive case study. Scans and other images will be displayed, and users can hone their interpretive skills by making their own diagnoses and receiving expert feedback. The first case, presented by the University of Arkansas's DuBose, involves an unusual case of placenta previa, a potentially life-threatening condition in which the placenta blocks the birth canal.

Future plans call for incorporating RealVideo technology, which allows users to download and play video movies. Such moving images are integral to the use of real-time ultrasound. "Ultrasound is a very visual science," comments Speyer. "We see the ultrasound section as an incubator where we can develop our visual technology for use in other sections of the OBGYN.net site."

Ashley Hill regards the Web as a valuable way to expand opportunities for both learning and teaching. "Communication with physicians in other countries has broadened my perspective," says Hill, who is Associate Director of the Department of Obstetrics and Gynecology at Florida Hospital in Orlando and the Florida State Representative for OBGYN.net. "People in different countries might approach things differently, but the outcomes are the same. There's more than one way to skin a cat." Recently, he notes, he has learned about approaches to surgical management of urinary incontinence using new techniques, suture materials, and grafts. "I've applied these new methods to my practice with good results," he says.

Hill has also used the Web to raise his colleagues' awareness of a technique called sonal hysterography, which involves inducing sterile water into the uterus followed by vaginal ultrasound. "The technique is starting to catch on," notes Hill, who has published a number of papers on the topic. In recent months, subscribers to the email list have exchanged advice and pearls of wisdom about which approach works best for which indications.

Patients will benefit from the new ultrasound section as well, believes Hill, who devotes a great deal of time to education. Among his other activities, Hill replies to patient questions garnered through Medscape, another major Web site with a section dedicated to women's health issues. "I think it's a great opportunity," he says, "because a picture is worth a thousand words. In my practice I keep a file of about 200 pictures I've taken during surgery. When I discuss a patient's condition, I can pull out a picture and say, 'This is what I suspect is wrong with you.' Many times I see the woman's eyes light up as she says, 'Now I understand.' Using images makes it easier for me to educate my patients." The ultrasound section will support this effort. "Patients can see some of the things we're talking about," he says. "When the see exactly what their doctors are talking about - fibroids, endometriosis, cancer - they realize why we are concerned about their condition."

For Julia Ann Drose, another advisory panel member, the ultrasound section offers an opportunity to raise awareness about the need for quality. "When I first started fifteen years ago, ultrasound was a very specialized field," says Drose, who is Assistant Professor in the Division of Diagnostic Ultrasound at the University of Colorado Health Sciences Center and author of the forthcoming book Fetal Echocardiography (W. B. Saunders Co.). "Now, advances in the field have made it possible for many physicians to offer ultrasound within their own practices."

She emphasizes that, unlike CT scans or MRI, the results of ultrasound depend to a great extent on the skills of the person using the technology. Drose hopes that the rapid and expanding exchange of information made possible by the Web will raise awareness of the importance of appropriate training, and that patients will seek ultrasound only from accredited clinics and qualified physicians.

Drose sees the new ultrasound section as an exciting opportunity for women to learn more about an increasingly important aspect of their health care. "Many women today turn to the Web as a source of information about their bodies and their medical conditions," she observes. "For those who search for sites about ultrasound, this one will be very useful. The ability to quickly find information about the facilities offering ultrasound, about specific anomalies and problems, is a big advantage."

OBGYN.net (http://www.obgyn.net) is developed by Elecomm Corporation, an Austin, Texas-based Web services company.