Professor Arvo Oksala was the earliest pioneer of diagnostic ultrasound in Finland and one of the earliest and most well-known ultrasound pioneers in the world. An ophthamologist, Oksala adapted the use of the A-mode metal flaw detector in 1956 to ocular diagnosis and reported on the localization of foreign bodies in the eye in 1957. Between 1957 and 1964 he produced a series of papers which laid important foundations for the ultrasonic diagnosis and measurement in eye diseases.

The Department of Obstetrics and Gynecology at the Oulu University was the first Department in Finland to have started using diagnostic ultrasound in Obstetrics and Gynecology. This was 1966, a time when much of the initial prototype equipment had improved and ultrasonography is getting established as a reliable and useful diagnostic modality. The first equipment in the department was an A-mode machine from Kretztechnik® of Austria. A combined A- and B- mode scanner from Kretztechnik® (Combison) was soon aquired in 1969. In 1973 a Siemens® Vidoson was also installed allowing real-time study of the fetus. Subsequent additions in equipment brought in the newer grayscale B-mode scanners.

Paavo Pystynen, who was at that time Assistant Professor of the department (he became Professor of Obstetrics and Gynecology at the University of Tampere since 1976), contributed the first paper on ultrasound applications entitled: "Detection of turbidity in amniotic fluid by an ultrasonic technique" which appeared in the Acta Obstet Gynecol Scand in 1966. The team of Paavo Pystynen, Pekka Ylostalo and Pentti Jarvinen followed on with a number of important early publications up to the early 1970s. Three other papers: "Foetal cephalometry by ultrasound", "Placental localization by ultrasound" and "Detection of foetal life in early pregnancy by ultrasonic Doppler inspection" appeared in 1967. Ylostalo reported very importantly in 1971 the usefulness of ultrasound in detecting early fetal cardiac pulsations which resulted in a marked reduction in hospital stay in patients with threatened abortion. In 1971 he reported 100% detection of fetal heart action via the vaginal route.

Pentti Jouppila, who is now Professor and Head of Obstetrics and Gynecology at the University of Oulu, graduated in 1966 and joined the team in ultrasonic investigations. He published his first paper: "Diagnosis of hydatid mole with one-dimensional ultrasound technique" in 1968 with Pystynen and Ylostalo. In 1970, he authored the paper: "Fetal head growth measured by ultrasound in the last few weeks of pregnancy in normal, toxaemic and diabetic women with Pystynen and Ylostalo. In 1970 he contributed a comprehensive review on the "Experiences of the use of ultrasound in the diagnosis of early pregnancy". Another colleague was Aimo Ojala who published: "Fetal chephalometry by ultrasound in normal and complicated pregnancy" with the group in 1970. Many other publications soon followed and colleagues at Helsinki and Turku had also started ultrasonic investigations by about 1969.

These included Olli Piiroinen who was working at the University of Turku and published on the localization of intrauterine contraceptive devices in 1972, which at that time was a relatively new indication for a gynecological ultrasound examination. He scanned women before and after an insertion and was able to detect the shape of the devices in utero. He continued to contribute to the advancement in ultrasound applications in Finland. Jaakko Jääskeläinen was a radiologist working with diagnostic ultrasound at the University of Helsinki. Together with Usko Nieminen, specialist in Gynecological Oncology at the University, applied ultrasound to perform planimetry in cervical cancer treatment planning. They had bought in a newer scanner the Portascan 661-BU from Picker® in the United States.

Pertti Kirkinen joined the Oulu department in late 1970s and contributed to prenatal sonographic diagnosis using the real-time scanner, and later on doppler investigations. In 1981, they published their first paper on fetal blood flow in: "Umbilical venous flow as indicator of fetal anaemia" in the Lancet. (Kirkinen P, Jouppila P, Eik_Nes S). This was followed by further work on quantitative and spectral fetal blood flow. Jouppila and Kirkenin's work importantly demonstrated (in 1981) that quantitative umbilical venous flow became unrecordable in fetuses with severe growth retardation and (in 1984) a significant negative correlation existed between umbilical venous flow and the cord haemoglobin.

Ultrasonic investigations have become a salient part of research activities at the Department of Obstetrics and Gynecology, University of Oulu since the early days of the 1960s and the department has now established itself as an important center for maternal and fetal medicine and prenatal ultrasound diagnosis.

Pentti Jarvinen passed away in 1988 and Paavo Pystynen in 1989. Pekka Ylostalo became Professor at the Helsinki University Central Hospital and Pertti Kirkinen is now Professor of Obstetrics and Gynecology at the University of Kuopio, Finland.







The author wish to thank Professor Jouppila for his help in preparing this page.


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