Gynecological ultrasound


What is it about ?

Ultrasound is an imaging technique using ultrasound-like sound waves. A probe emits this ultrasound. They are then sent back to the probe after having “bounced” (reflected waves) off the elements present in your body. These reflected waves are converted into images on a screen. The gynecological ultrasound thus makes it possible to visualize the uterus and the ovaries. As this technique does not use radioactive rays, it is safe for both the woman and the unborn child.

Gynecological ultrasound can be performed by placing the probe on the woman’s stomach, but also sometimes by sliding it inside the vagina (vaginal ultrasound), which allows you to see the details better.

What is it used for?

The gynecological ultrasound can provide the doctor with useful information during a routine exam (for example, pregnancy) or when he suspects a gynecological problem.

  • It is used to assess the maturation of the egg during the normal menstrual cycle. The doctor can see if ovulation has occurred and if the conditions for normal fertilization and pregnancy are present.
  • At the start of pregnancy, the gynecological ultrasound will always be performed through the vagina. From the fifth week of pregnancy, the amniotic sac and yolk sac are visible in the uterus. At the end of the fifth week, the heartbeat can be seen next to the yolk sac. During the sixth week, the distance from the top of the head to the bottom of the fetal buttocks (cranio-caudal length) can be measured. From the eighth week of pregnancy, you can see the movements of the head and limbs.
  • When there is a threat of miscarriage, the woman has bleeding, but the fetus is alive and the heartbeat can be detected.
    If the fetus is no longer alive and the woman still has little or no bleeding, it is called a “missed miscarriage”. The fetus is dead, but not expelled.
    If the bleeding is profuse and the ultrasound shows what professionals call a ‘mixed picture’, the woman is having a spontaneous miscarriage.
  • In case of ectopic pregnancy or ectopic pregnancy, the embryo implants [SL1] outside the uterus, in 95% of cases, in one of the fallopian tubes.
  • Both benign and malignant ovarian tumors can be seen on an ultrasound through the vagina.
    In polycystic ovary syndrome (PCOS), there are different cysts, sometimes large in size. Cysts are pockets or cavities, usually filled with fluid.
    In case of inflammation of the small pelvis, the fallopian tubes may appear very thick on ultrasound with the presence of pus and inflammatory fluid.
    Normal fallopian tubes cannot be seen on an ultrasound. To see them, you need a contrast medium. This contrast agent is used mainly in the event of a fertility problem.
  • If a woman has vaginal bleeding, a gynecological ultrasound is done to rule out a tumor in the uterus. Ultrasound cannot distinguish between a benign tumor, such as a polyp or simple fibroid, and a malignant tumor. Changes in the lining of the uterus can also be seen.
  • The position of an IUD (whether hormonal or copper) is checked by vaginal ultrasound.

How should you prepare for the exam?

As the internal structures are more visible when the bladder is empty, you should urinate before the exam.

In principle, vaginal bleeding is not a reason to postpone an ultrasound. In the event of very heavy blood loss, it may sometimes be necessary to put a sterile gel into the uterus in order to see the lining of the uterus better.

Want to know more?

Source

Foreign clinical practice guide ‘Gynecological ultrasound’ (2000), updated on 03.08.2015 and adapted to the Belgian context on 20.05.2019 – ebpracticenet