Ultrasound examination - determination of pathological changes in tissues and organs using ultrasound. Ultrasound is based on the mechanism of echolocation, that is, the reception of signals sent and then reflected from the interfaces of tissue media with different acoustic characteristics. Ultrasound examination of the pelvic organs is done to visually determine the presence of a particular disease in a woman by echographic properties (with obstetric ultrasound - in the fetus). Such an examination in gynecology is basic, that is, its results form the basis of other diagnostic procedures.
Methods of the procedure
Modern methods of such diagnostics generally exclude discomfort and pain. Ultrasound examination of the pelvic organs should be done in all women if there are suspicions of various reproductivepathology.
Specific ultrasound diagnostic methods are used.
- Transabdominal examination. The organs that are in the small pelvis are examined through the wall of the peritoneum, while the sonologist runs a sensor over the skin of the abdomen, thanks to which he can obtain information about the state of a particular organ. During the procedure, you need to have a full bladder. The doctor in the course of the study can establish the specifics of the structure of the genital organs from the inside, see formations and deviations in them.
- Transvaginal ultrasound of the pelvic organs - a gynecological examination is carried out through a special sensor inserted into the woman's vagina. This diagnostic method allows you to see in detail the structure of the analyzed organs and determine their size.
- Combined diagnosis initially requires transabdominal diagnosis when the bladder is full. After emptying it, the doctor performs a transvaginal examination.
- Transrectal examination requires the insertion of an ultrasound transducer into the rectum. This method is used when the girl is not yet sexually active.
The specifics of the procedure
Ultrasound examination of the pelvic organs is carried out either with a vaginal (vaginal) or abdominal (through the abdomen) probe. In the pelvis of the patient, ultrasound examines the bladder, ovaries, vagina, fallopian tubes and uterus.
- Uterus: the shape, position, structure of the walls and the main dimensions of the organ are established. In addition, with ultrasound (ultrasoundstudy of the pelvic organs) examine separately the median structures of the uterus: the endometrium and the uterine cavity. If a woman is not pregnant, her uterine cavity is slit-like. The endometrium, that is, the inner functional layer, is characterized by a change throughout the cycle of menstruation.
- Ovaries: position in relation to the uterus, size of the ovaries, corpus luteum (the formations that remain in place of the follicles when the egg is released from the ovary) and follicles are determined. Corresponds to the period of the menstrual cycle. When formations are diagnosed in the ovaries, they are also described (size, structure, shape). In addition, the presence of free fluid is established (after the release of the egg from the ovary, there is normally a little of it) and the presence of a tumor in the pelvic cavity. In addition to the structure of the ovaries and uterus, during an ultrasound, the condition of the bladder is examined (if it is sufficiently full).
Many wonder where you can do an ultrasound of the pelvic organs. More on that below.
Dignity of procedure
Ultrasound examination is carried out quickly, this method is not burdensome, accessible and clear, can be used repeatedly, requires minimal preparatory conditions before the procedure. Ultrasound has been proven to be completely safe, even for pregnant women.
Indications for the procedure
The ultrasound method has a wide application if there is a suspicion of pregnancy, gynecological diseases, to monitor the treatment of a woman and the coursepregnancy.
Using ultrasound, you can diagnose the position of the patient in the early stages. In women, pelvic ultrasound should be performed in case of menstrual cycle failures (beginning of menstruation ahead of time, delay of critical days, bleeding in the middle of the cycle), with scanty or heavy menstruation, if menstruation is absent, with various vaginal discharges, discomfort in the lower abdomen, if there are discharge during menopause.
Using ultrasound in gynecology, various diseases are determined: from gynecological inflammatory diseases to malignant and benign formations of the ovaries and uterus (including ovarian cysts, salpingo-oophoritis, endometriosis and others).
The study of the uterus allows you to diagnose uterine fibroids at an early stage.
Pelvic ultrasound is used to monitor the ovarian follicular apparatus if pregnancy is planned, as well as in the treatment of infertility.
The procedure is required when taking hormonal and contraceptives, if there is a contraceptive inside the uterus (spiral) in order to control and avoid complications.
Research during pregnancy, that is, obstetric ultrasound, makes it possible to monitor the normal development of the baby and timely determine the pathology.
Ultrasound of the small pelvis in urology is necessary to determine the causes of urination disorders, diseases of the urethra (urethra) and urinary incontinence. There are no contraindications for ultrasound examination.
Preparing forprocedure
You can do an ultrasound of the pelvic organs in any medical institution where there is technical equipment.
If you plan to conduct ultrasound diagnostics, then after the examination to remove the remaining gel from the skin, you will need to have a napkin or towel with you, and a diaper that is covered on the couch during the procedure.
For non-pregnant women, a simple gynecological ultrasound is performed on a full bladder, unless otherwise specified by the doctor. To ensure maximum reliability and accuracy of the results, you must strictly adhere to the established norms for preparing for the ultrasound procedure:
- transabdominal - requires preparation: you need to drink from a liter to one and a half still water 60 minutes before the examination and do not urinate before the procedure;
- transvaginal, the study is done with an empty bladder;
- obstetric (during pregnancy) is done with a moderately full bladder (you need to drink two glasses of fluid an hour before the examination).
What does a pelvic ultrasound protocol require? If the organs of the genitourinary system (ovaries, uterus, prostate, bladder) are being studied, you need to drink half a liter of liquid an hour and a half before the procedure or not urinate for two hours. This is necessary to fill the bladder, which will push the examined organs.
For a successful study, a prerequisite is the absence of gases in the intestines. That is why preparing for an ultrasoundshould be done in advance: 2-3 days before the proposed procedure, follow a diet, limit foods in the diet that cause gas formation or constipation. It is recommended to remove from the menu products that provoke the formation of gases: milk, confectionery, raw vegetables, fruits, black bread. It is advisable to take enzymatic agents: Creon, Enzistal, Panzinorm, Festal.
Cleansing enemas are not recommended as they often increase gas production. In addition, it is allowed to drink dill water, Espumizan and activated charcoal. If the patient is constipated, it is advisable to drink a laxative, especially if it is necessary to conduct a study using a rectal probe.
The procedure is done on an empty stomach (the last meal should be 8-12 hours before the ultrasound) and immediately after emptying.
On what days should a pelvic ultrasound be done? Let's figure it out. Examination of the uterus, mammary glands, appendages is preferably carried out in the first half or middle of the menstruation cycle. Ultrasound for folliculogenesis is done on the fifth, ninth, eleventh to fourteenth and fifteenth days of the cycle.
Ultrasound of the pelvic organs is a very accurate procedure, but in many respects the accuracy of the results will be determined by the correct preparation for the study. In emergency situations, ultrasound is done without preparation, but its effectiveness will be reduced.
Procedure
The woman lies down on the couch, spreading the diaper to the doctor with her head (that is, to the ultrasound machine), exposing the lower abdomen andthe belly itself. The doctor lubricates the ultrasound transducer with a special gel (if the ultrasound is transvaginal, a condom is put on the transducer and also lubricated with gel). Then the specialist drives the sensor, sometimes pressing to view the pelvic organs from different angles. This procedure is completely painless, except for the diagnosis of inflammatory acute processes in the body. The procedure lasts from ten to twenty minutes, depending on the goals of the pelvic ultrasound. On which day of the cycle this study is carried out, it must be taken into account.
Ultrasound Complications
There are no complications after the ultrasound examination. However, during pregnancy, transvaginal ultrasound (especially in the early stages) is performed only after assessing the danger to the baby.
Main indicators of the norm during ultrasound
Patients will be useful and interested in information about the norm of indicators of ultrasound examination of the pelvic organs in women.
- Normally, the uterus is located in the center of the pelvis, closer to the front wall. When conducting a longitudinal scan, the organ has a pear-shaped shape, and a transverse one - egg-shaped. The normal uterus is characterized by medium echogenicity. Its internal structure is homogeneous, has linear and point objects. The size is approximately 5.2 centimeters, the width is five centimeters, the thickness of the body is 3.8 centimeters.
- The ovary cannot always be visualized. It is normally oval, echogenicity is average. Inside there are echo-negative dot inclusions.
- The vagina has a tubular shape that connects to the uterine cervix. Atin the transverse passage of the scan, it has an ovoid shape. The thickness of the vaginal wall is normally three to four millimeters.
- Ultrasonic indicators of the endometrium change, depending on the cycle of menstruation. When drawing up the protocol, the day is taken into account.
These indicators normally reflect a good ultrasound of the pelvic organs.
If there are other objects on the ultrasound examination and a change in echogenicity by certain organs, thickness and other indicators, this indicates the presence of certain diseases in the female body. If doubtful results appear, the patient needs to do additional examinations. Most often, a woman can be referred for a CT scan or MRI. In some cases, an ultrasound is prescribed again.
An ultrasound of the pelvic organs is interpreted by the same specialist.
What can the procedure diagnose?
Ultrasound can diagnose certain conditions.
- Congenital developmental disorders. The use of ultrasound, especially three-dimensional, allows you to see anomalies of uterine development (doubling of the organ, unicorn, saddle, bicornuate). The presence of anomalies from birth can provoke infertility, increase the likelihood of preterm birth, intrauterine death of the baby, spontaneous abortion, fetal position and labor defects.
- Uterine fibroids, that is, a benign tumor of the female reproductive system. DuringUltrasound diagnoses the number, presence, size and location of myomatous nodes. In addition, ultrasound makes it possible to monitor the dynamics of their growth rate. That is why they do ultrasound several times a year. The diagnosis of fibroids is very important in preparation for pregnancy, as their presence can affect the course of pregnancy.
- The pathological process of the spread of the endometrium outside the uterine cavity - endometriosis (in the peritoneum, on the ovaries, the walls of the uterus). The study determines adenomyosis (when the endometrium grows into the uterine wall) or internal endometriosis, endometrioid ovarian cysts. The diagnosis of the disease is very important in predicting pregnancy (due to endometriosis, there may be infertility) and its bearing.
- In pregnancy: thanks to ultrasound, pregnancy can be diagnosed from 3-4 weeks. For short periods, it is determined exclusively by means of a transvaginal sensor, since the device has good resolution. Different types of ectopic pregnancy are determined (cervical - when the fetal egg is attached to the uterine cervix, tubal - when the fetal egg is attached to the zone of the uterine tube, cervical - when the fetal egg is attached to the ovary), thanks to which women's he alth can be preserved.
- Intrauterine protection: using ultrasound, you can control the process of installing and removing a contraceptive inside the uterus, in time to determine the wrong location, complete or partial prolapse of the IUD from the uterine cavity, ingrowth of parts of the contraceptive into the wall of the uterus. When planning a pregnancy after removing the contraceptive fromuterus, the doctor will advise an ultrasound.
- In addition, hyperplastic endometrial processes (malignant tumors, polyps, hyperplasia), large ovarian formations are determined.
What is included in a prophylactic pelvic ultrasound?
Preventive ultrasound
For preventive purposes, he althy women are advised to do an ultrasound examination of the pelvic organs once every one or two years, after the age of forty - once a year to determine hidden diseases. Preventive ultrasound is usually done in the first phase of the monthly cycle, specifically from day 5 to day 7.
We looked at what is included in the ultrasound of the pelvic organs.
