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.
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• 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.
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• 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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• 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
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• Possible fetal demise.
• Presentation & lie.