Pelvic ultrasound (transvaginal): Difference between revisions
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[[File:free_fluid_ectopic.png|thumb|Free fluid in cul-de-sac, no gestational sac visualized in uterus]] | [[File:free_fluid_ectopic.png|thumb|Free fluid in cul-de-sac, no gestational sac visualized in uterus]] | ||
[[File:simple_cyst.jpg|thumb|Writing that you want on the bottom of the photo]] | |||
[[File:hemorrhagic_cyst.jpg|thumb|Hemorrhagic cyst with blood clot]] | |||
==Pearls and Pitfalls== | ==Pearls and Pitfalls== | ||
Revision as of 23:28, 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: Measured from thickest echogenic area (from one basal endometrial interface to the other, including canal)
- 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
- Pre-menopausal:
- Adnexa:
- Simple ovarian cyst: <2.5-3cm
Images
Normal
Abnormal
