ULTRASOUND

GYENAECOLOGY & OBSTETRICS

ULTRASOUND

• Sonography is is effective method of examining female pelvis.

• Technique is essentially risk free.• Provides excellent visualization of pelvic

viscera..• Done either through distended bladder or

transvaginal approach.

PELVIC ULTRASOUND

• Pelvic sonography should be viewed not as a diagnostic procedure but as a adjunct to physical examination.

• It usually answers following questions:• Is the pelvis normal or abnormal.• What is the origin of mass detected by

physical examination.

PELVIC ULTRASOUND

• What are the gross characteristics of pelvic lesion.

• Does the sonographic appearance of a pelvic lesion matches the clinical impression.

• Is a pelvic lesion regressing or enlarging.• What is the status of the female reproductive

organs in patients with delayed menarche, precocious puberty, infertility or congenital anomalies.

PELVIC ANATOMY

• Ultrasound examination is performed through a full bladder.

• The basic orientation structure is Uterus.• Uterus and each broad ligament divides the

pelvic peritoneal space into anterior uterovesical pouch & posterior Pouch of Douglas/ Rectouterine pouch/ Cul-de-sac.

• Cul-de-sac is good to see for pelvic collection/ pelvic peritoneal deposits.

PELVIC ANATOMY

• The size & appearance of normal uterus is dependent upon age.

• The normal non pregnant uterus measures 6-10cm in length.

• The prepubescent uterus is smaller e.g 4 cm.• In old age again it is atrophic and small in size.• The Post partal uterus is large in size and may

take months to involute to kits regular size.

PELVIC ANATOMY

• Anatomically normal uterus is anteverted & anteflexed.

• Retroverted uterus is by no means abnormal but it is sometimes difficult to find early pregnancy sac echographically in this type of uterus.

OBSTETRIC ULTRASOUND

• Common obstetric problems addressed with ultrasound.

• No. of gestations. When uterus is large for dates or following fertility enhancement procedures like IVF.

• Pregnancy location- intrauterine or ectopic.• Uncertain dates.

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OBSTETRIC ULTRASOUND

• Uterus small for dates. Incorrect LMP, growth retardation, olighydramnios, fetal urinary tract problems etc.

• Uterus large for dates. Incrrect LMP, multiple gestations, hydatidiform mole, fibroid or other pelvic mass, polyhydramnios, Meternal diabetes etc.

OBSTETRIC ULTRASOUND

• Risk of fetal Anomaly.• Vaginal Bleeding. In first trimester, it could be

incidental or pregnancy failure.• In later pregnancy Placenta previa, placental

abruption.• Pain during pregnancy. Abruptio placentae,

haemorrhagic lieomyoma, ovarian tumours/ cysts, appendicytis, cholecystitis.

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OBSTETRIC ULTRASOUND

• Possible fetal demise. • Presentation & lie.