Pelvic ultrasound (transvaginal)

Background

• Also known as endovaginal ultrasound
• Used to evaluate female reproductive organs including uterus, ovaries, fallopian tubes, cervix, and vagina

Indications

• Abnormal uterine bleeding
• Abnormal abdominal or pelvic exam
• Pelvic pain
• Confirm intrauterine pregnancy
• Gestational dating during pregnancy
• Fetal monitoring and surveillance
• Evaluation of placenta
• Evaluate for spontaneous abortion
• Evaluate for ectopic pregnancy
• Uterine fibroids
• IUD placement confirmation
• Ovarian torsion
• Ovarian cysts

Technique

• Probe and transducer
  • Endocavitary probe (high frequency, low penetration)
  • Probe "dot" stays on left side of ultrasound screen
    • Corresponds with anterior structures (if probe marker held at 12:00) and right-sided structures (if probe marker held at 9:00)

• Patient positioning
  • Lithotomy position
  • Gently advance probe into vaginal canal
  • May be more comfortable for patient to insert probe into vagina herself

Images

Abnormal

Ectopic pregnancy at the cervix