Pelvic ultrasound (transvaginal): Difference between revisions

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==Findings==
==Findings==
*Endometrial stripe
**Pre-menopausal:
***During menstruation: 2-4mm
***Early proliferative phase: 5-7mm
***Late proliferative phase: 11mm
***Secretory phase: 7-16mm
***After D&C or SAB: >5mm
****Consider retained POC if thicker
**Post-menopausal:
***With vaginal bleeding: <5mm
***Without vaginal bleeding: <11mm





Revision as of 21:27, 12 October 2017

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



Findings

  • Endometrial stripe
    • Pre-menopausal:
      • During menstruation: 2-4mm
      • Early proliferative phase: 5-7mm
      • Late proliferative phase: 11mm
      • Secretory phase: 7-16mm
      • After D&C or SAB: >5mm
        • Consider retained POC if thicker
    • Post-menopausal:
      • With vaginal bleeding: <5mm
      • Without vaginal bleeding: <11mm


Images

Normal

Abnormal

Ectopic pregnancy at the cervix
Free fluid in cul-de-sac, no gestational sac visualized in uterus

Pearls and Pitfalls

Documentation

Normal Exam

Abnormal Exam

Clips

External Links

See Also

References