Vaginal and transvaginal ultrasound. Transvaginal ultrasound: all about the wonderful ultrasound method during pregnancy transvaginal method

Date of: 18.08.2020

Transvaginal ultrasound is a more reliable method of diagnosis in comparison with others. This is due to the proximity of the apparatus to the female genital organs. Such a medical study is based on the supply of ultrasonic waves through a special sensor that is placed in the vagina.

This ultrasound examination is performed vaginally and is instrumental method, with the help of which the doctor will be able to make an accurate diagnosis, and in the future prescribe effective treatment ailment.

In modern gynecology, this diagnostic method is called differently:

intravaginal examination;
intravaginal examination;
vaginal examination of the organs of female reproduction.

The generalized name is transvaginal ultrasound.

Often, when performing an ultrasound examination, doctors use a special technology for visualizing blood flow - color Doppler mapping. With the help of color doppler, it is possible to assess the resistance of blood vessels, their diameter and patency, as well as other pathological processes.

Intravaginal ultrasound examination of the genitals can be used as a separate diagnostic method, or in combination with a transabdominal examination (through the walls abdominal cavity) or palpation.

Indications for carrying out

The doctor may refer the patient for transvaginal ultrasound in the following cases:

at painful sensations lower abdomen;
inflammatory diseases of the female genital organs;
pathologies of the urinary system;
implementation of artificial insemination;
use hormonal contraception, installation of a spiral or vaginal ring;
irregular menstruation;
suspicion of infertility;
pain during intercourse or immediately after it.

An intravaginal examination is also used to determine pregnancy. This method is more informative than the standard transabdominal examination and allows you to clearly see the picture of the uterus.

Advantages of the method

The intravaginal diagnostic method has its positive aspects:

availability;
harmlessness and safety of ultrasound for the patient;
does not require thorough preparation;
high level of image detail;
carried out without filling the bladder;
can be used for obese women (when other methods of examination cannot be implemented).

In addition, thanks to vaginal ultrasound, the doctor will be able to examine in detail the cervix (which is poorly visualized during abdominal examination).

Preparing for a transvaginal ultrasound

This type of procedure does not require special preparation.

take a hygienic shower before the examination;
take with you a disposable diaper, dry wipes and a special condom for intravaginal ultrasound (sold in every pharmacy);
empty one hour before manipulation bladder;
one day before the study, it is undesirable to have sexual intercourse.

Preparing in advance should be women who are concerned increased gas formation. It is better to do an ultrasound after taking medicines, they will help reduce flatulence (Espumizan, Smecta).

On what day of the cycle do

Most right time for examination - the first days of the cycle after the end of menstruation. It is recommended to do an examination on the 5-8th day of the menstrual cycle. The reliability of the sensor readings will depend on when the patient last ovulated. As a rule, it occurs 12-14 days after critical days, subsequently, the state of the reproductive organs changes markedly.

If you suspect endometriosis of the uterus (growth of endometrial tissue), the procedure is transferred to the second part of the cycle.

Transvaginal ultrasound during menstruation is not recommended. However, certain pathologies of the pelvic organs (polyps, fibroids, small cysts) can be seen only in the first days of menstruation.

How is the procedure?

Before the examination, the woman must remove all clothing below the waist. In order for the small pelvis to bring less discomfort, you need to take care of the form of clothing (come to the examination in a skirt or dress).

The procedure is carried out as follows:

The woman lies on the couch lying on her back. In this case, you need to bend your legs and slightly spread them at the knees.
Next, the doctor puts a condom on the sensor and lubricates it with a special gel. It will help eliminate air between the internal organs and the device, and will also contribute to better penetration.
The reproductive organs are displayed on the screen, and the doctor voices the data.

A nurse takes part in the implementation of the procedure, she records the results of the study in the protocol.

In the absence of sudden movements, it is not painful and is not accompanied by other unpleasant sensations.

Photo gallery

Device Introduction Ultrasonic sensor (photo) Direct procedure

What does a vaginal ultrasound show?

An intravaginal examination can show the following conditions and diseases:

malignant and benign tumors reproductive organs;
uterine myoma (neoplasm in muscle layer such a female genital organ);
fluid in the pelvic area;
endometriosis;
full or partial hydatidiform mole;
blood, purulent formations in the tubes of the uterus;
inflammatory processes.

Deciphering the results

This procedure is carried out by a specialist who, at the end of the manipulation, will provide the patient with the results and conduct a consultation to compare them with the norm.

Table of norms of ultrasound of internal organs

Parameter	Echo Pattern Norm	Symptom pathology
Ovarian size	Length: 20–25 mm. Width: 12-15 mm. Thickness: up to 12 mm. Volume: up to 4 cu. cm. Smooth and clear contours	The enlarged size of the ovaries, as well as their uneven contours, may indicate polycystosis, congenital anomalies, and oncological processes.
The position of the uterus and its size	Length: 16–62 mm. Width: 15–60 mm. Thickness: 12-48mm. In girls who are not sexually active, as well as in women during menopause, the uterus is smaller. In women who have given birth, the size of the organ will be larger. The contours of the organ should be even and smooth. The uterus has an inflection in front or slightly behind.	Increased size of the uterus and blurred contours can be observed in various inflammatory diseases. Tuberosity and compaction of the organ indicates pathologies of an oncological nature. Incorrect location of the organ can be the cause of infertility or abortion (unauthorized).
The surface of the cervix	Clear contours and smooth surface	Blurring of the contours indicates congenital anomalies or inflammation.
The fallopian tubes	Not rendered	Wall thickening, diameter increase fallopian tubes, fluid accumulation is observed at ectopic pregnancy or inflammation.
free liquid	Present in small amounts behind the uterus during ovulation	A large volume of fluid is a sign of an inflammatory process.

Ultrasound of the uterus and appendages

This study is a scan:

vaginal cavities;
uterus;
ovaries;
fallopian tubes.

This diagnostic method allows you to determine the following pathologies:

adnexitis (inflammation of the appendages and uterus);
fibromyoma;
leiomyoma (benign tumors);
neoplasms on the cervix;
ovarian cancer.

bladder ultrasound

This study is used as an alternative to palpation or catheterization (the introduction of a special medical instrument through the urinary system, which is carried out for various purposes).

Indications for an ultrasound examination of the bladder may be the following:

frequent urination or its delay;
blood in the urine or detection of red blood cells;
cystitis;
various organ injuries.

Ultrasound of the pelvic organs

Is comprehensive examination, during which the doctor, at his discretion, determines the need to examine a particular organ. Intravaginal ultrasound of the anatomical space can be performed with. This method allows you to identify violations of blood vessels (pelvic) and show in more detail the image of other pathological processes.

Transvaginal ultrasound during pregnancy

This method of examination is widely used in obstetrics and allows you to display the image of the uterus and fetus on the screen monitor and take a picture. Transvaginal ultrasound reflects the developmental features of the child. As a rule, the doctor prescribes a scanning procedure for a pregnant woman in the first trimester.

General indications for the appointment of intravaginal ultrasound for early dates carrying a baby are as follows:

the need to establish the fact of fertilization;
control over the development of the fetus;
study of the periuterine space;
identification of possible threats of gestation.

Transvaginally or transabdominally?

The attending physician will help determine the method of examination. Due to the unique technology, intravaginal diagnostics is much superior to the study conducted through the walls of the abdominal cavity. In addition, the specialist can refer the patient to a vaginal ultrasound if she has postoperative adhesions on her abdomen.

How often can you do it?

IN preventive purposes to undergo a vaginal ultrasound should be prepared at least once a year.

As for the period of pregnancy, this method of ultrasound examination is allowed to be carried out up to the twelfth week. The doctor may prescribe a second procedure to determine the state of health of the woman or to exclude signs of a frozen fetus. Transvaginal examination is completely safe for the body of the mother and child.

Contraindications and complications

Doctors should not be allowed to perform intravaginal ultrasound for girls who are not sexually active. In this case, it is recommended to conduct an examination of the pelvic organs in only two ways: transabdominally or transrectally (through the rectum). In addition, the survey of this type it is forbidden to exercise in the second or third trimester of pregnancy.

The implementation of the procedure is not accompanied by any complications. In case of discharge of a different nature, it is recommended to visit a specialist.

Care after the procedure

Many patients after intravaginal ultrasound are in a hurry to douche. However, without a doctor's prescription, no additional hygiene procedures should be carried out.

How much does the procedure cost?

Video

A qualified specialist will tell you about the main indications for the pelvic organs. Published by Kaluga Pain Clinic.

Women need to take care of their health reproductive system at any age, for this purpose it is necessary to visit a gynecologist regularly. However, situations may arise when a gynecological examination is likely to be insufficient to determine the pathology and make a diagnosis. In this case, the patient usually receives a referral for a transvaginal ultrasound. But not all women agree to this procedure: someone is embarrassed by the process itself, someone is afraid of pain, someone has prejudices due to lack of information about the study.

In any case, a transvaginal ultrasound really needs to be done if the circumstances warrant it. What it is? Does it really hurt? What is the preparation? Isn't it dangerous this study during pregnancy and especially in the early stages? And why even resort to this particular diagnostic technique when there are similar?

What is such an ultrasound?

Transvaginal ultrasound is an examination of the pelvic organs (uterus, ovaries, fallopian tubes, cavities) using ultrasound with a special sensor that a diagnostic specialist inserts into the vagina.

Why do an ultrasound like this? Is it really necessary?

Only this type of ultrasound allows you to give the most accurate and reliable idea of the state of the pelvic organs. Transabdominal ultrasound (through abdominal wall) due to its specificity is not so informative and only virgins should choose it.

It should also be noted that transvaginal ultrasound is recommended not only in case of direct indications. In order to prevent and prevent the occurrence and development of deviations of varying degrees, pathologies and diseases, the specified study is also used.

It is especially important to do a transvaginal ultrasound during early pregnancy, this step is mandatory for every expectant mother, as it allows you to give objective assessment condition of the developing fetus.

Indications for such a study

Exists a large number of symptoms, with complaints of which experts recommend doing an ultrasound of the appendages. Traditionally they are:

minor bleeding;
profuse bleeding unrelated to menstruation;
pain of a different nature in the lower abdomen, as well as in the lumbar region;
prolonged menstruation (in terms of 7 days or more);
suspicion of pathology of the pelvic organs;
suspected ectopic pregnancy;
discomfort or pain during intercourse;
Availability infectious diseases pelvic organs, sexually transmitted;
infertility;
abnormal vaginal discharge;
the presence of an intrauterine device;
diseases genitourinary system(in some cases);
during early pregnancy.

What diseases can be detected by this diagnostic method?

Transvaginal ultrasound is very revealing and effective method research, so it can be used to diagnose many diseases and anomalies of the reproductive system. For example, it could be:

adnexal neoplasms (both benign and malignant);
various ovarian cysts;
Endometriosis (a disease in which the cells of the inner layer of the uterus - the endometrium - grow and grow into other layers);
endometrial polyps;
internal bleeding;
Delayed menstruation;
The presence of accumulations of fluid or pus both in the uterine cavity and in the area of \u200b\u200bthe appendages;
ectopic pregnancy with different localization embryo;
Apoplexy of the ovaries or cysts;
Endometritis (inflammation of the endometrium of the uterus);
Inflammatory processes of the pelvic organs;
Various pathologies of the uterus.
Bubble skid (full or partial);
Malformations of the reproductive system.

In the examination conducted in this case, no deviations were found. Uterus normal sizes 66 x 19 x 34. The endometrium is also normal, its thickness is 8.1 mm. myometrium and serosa also does not detect anomalies. Normal fluid is found in the Douglas space.

Is specific preparation required for the study?

No, a woman does not need to carry out any special procedures in order to undergo such a study, however, you need to remember some points that must be observed before the study. So preparation consists in observing a simple hygienic algorithm immediately before going to the clinic. It is also necessary to conduct an examination on an empty bladder. A woman still needs to know that the procedure is not performed on the days of menstruation. Preparation also consists in freeing the intestines from excess gases that can interfere with the study: for this, a few days before the procedure itself, it is recommended to exclude products that stimulate increased gas formation, if necessary, take appropriate medications.

Condoms for transvaginal ultrasound transducers: a guarantee of safety and hygiene.

How is the process going?

The patient needs to undress below the waist, lie on the couch on her back or sit in a gynecological chair, bending her knees and slightly spreading them apart. Further, the doctor, for the convenience of conducting the study, uses a special elongated sensor, on which a condom is put on. Such a sensor is introduced into the body only with a special lubricant to facilitate the procedure and not damage the mucous membrane.

Next, the doctor looks at the image on the screen, if necessary, the specialist can turn the sensor at different angles to get a clearer image of the pelvic organs, for the same purpose, light pressure on the lower abdomen is possible. Since the sensor is in close proximity to the pelvic organs, the “picture” on the screen is more reliable and detailed. The result is a well-visualized projection of the uterus and pelvic organs.

Also, if necessary, the doctor may inject a contrast agent into the fallopian tubes to assess their patency.

It should be noted that transvaginal ultrasound is absolutely painless, and you should not be afraid of it. Only unpleasant sensations can arise, which have nothing to do with pain. Therefore, one should not believe the rumors that doing this research is painful.

Having completed the procedure, the diagnostic specialist analyzes the obtained indicators, draws a conclusion and applies pictures of the uterus and other components of the reproductive system in the presence of pathology.

What does this ultrasound show?

Analyzing echogenicity with a sensor, the diagnostician assesses the state of the tissues of the uterus and appendages, their integrity. The doctor also checks the location of the pelvic organs (uterus, ovaries, fallopian tubes) and their size for compliance with the norm (which in turn depends on the day of the cycle, but an experienced diagnostician can easily cope with this task). If necessary, it is possible to see the number of maturing follicles. The specialist also needs to evaluate the structure of the appendages, contours.

Can this test be done on pregnant women?

In early pregnancy, transvaginal ultrasound is a necessity, as it provides a clearer picture of fetal development than a simple gynecological examination. Ultrasound of the pelvic organs cannot cause any harm to the child, but the mother’s refusal of such a diagnosis in favor of transabdominal ultrasound can result in negative consequences. On the other hand, this type of research is possible only in the early stages and is potentially dangerous already in the second trimester, since it can cause miscarriage and other complications.

With the help of such a diagnosis, the doctor determines whether the fetus is developing (otherwise, a missed pregnancy is diagnosed); the doctor also notes the location gestational sac if it is outside the uterine cavity, then an ectopic pregnancy is definitely diagnosed.

Usually, transvaginal ultrasound during pregnancy is prescribed precisely in the early stages, most often it is done at the fifth or sixth week of pregnancy. Specific preparation for the study during pregnancy is not needed, you must adhere to the general rules for all. Ultrasonography transvaginal sensor during pregnancy is not painful at all.

Are there possible errors in the diagnosis after this ultrasound?

Since, due to its specificity, the type of ultrasound examination under consideration is a priority for diagnosing the reproductive system of a woman, the following conclusion can be drawn: the probability of error is minimized here. An experienced diagnostician is always able to distinguish one pathology from another. Only in especially severe cases is there a possibility of an incorrect diagnosis, which may require additional examinations to clarify.

Thus, transvaginal ultrasound is a unique technique in terms of information content, which is an indispensable assistant to a gynecologist. Such a study is safe and it is not painful for patients to do it.

A vaginal ultrasound (transvaginal ultrasound) is a procedure performed to examine the condition of the pelvic organs in women. This method diagnostics is carried out using a special ultrasonic sensor. The main task of such an ultrasound examination is to evaluate the work of the internal genital organs of a woman (uterus, ovaries, cervix, fallopian tubes), as well as the genitourinary system. Vaginal ultrasound is much more informative than studies conducted on the outer part of the body, since in this case the sensor is located in close proximity to the organs under study. Therefore, transvaginal ultrasound allows you to get more accurate and objective information about the work and condition internal organs and their systems.

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Ultrasound with a vaginal sensor has made a huge step forward in such branches of medicine as obstetrics, gynecology and urology. Transvaginal ultrasound makes it possible to detect the disease even at the stage when the first symptoms are absent, the woman does not even suspect about possible illness. Vaginal ultrasound allows you to detect changes in the pelvic organs at the moment when they are just beginning to affect the walls and mucous membranes. Most often, at this stage of the disease, any other diagnostic methods are not so informative, and some do not even show any violations and changes.

Transvaginal ultrasound is performed in such cases as:

spotting from the vagina in the middle of the menstrual cycle (regardless of their color and abundance);
no pregnancy for more than six months with a full sexual life without the use of contraceptives;
any pain in the lower abdomen, not related to menstrual pain;
with abnormal duration of menstruation;
to exclude ectopic pregnancy (performed from the third week of pregnancy);
with pain in the lower part of the abdominal cavity during intercourse;
as an annual preventive diagnosis.

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Transvaginal ultrasound helps to identify the following diseases and pathological changes:

cystic formations ovaries;
endometriosis of the uterus;
pregnancy (uterine and ectopic);
the presence of fluid, pus or blood in the fallopian tubes, which causes the presence inflammatory processes in them (without differentiation of these liquids);
detection of fibroids in the uterus and polyps in the endometrium;
establishment of anomalies in the development of internal genital organs;
cystic drift (both partial and complete);
cancerous tumors in the uterine cavity;
ruptures of cystic formations in the appendages;
the presence of fluid in the lower abdominal cavity;
malignant formations of appendages;
chorionepithelioma.

Vaginal ultrasound allows you to establish the number of follicles that are in the process of development, as well as assess their quality and detect various features. If transvaginal ultrasound is performed with the introduction of a contrast agent into the fallopian tubes, it is possible to assess their patency, detect polyps and give a prognosis for the passage of a fetal egg.

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Thanks to this study, the attending physician will decide on the treatment of obstruction of the fallopian tubes, which will allow you to conceive a child if the woman plans to become pregnant. Vaginal ultrasound is also performed if it is necessary to assess the dynamics of the development of the fetal egg. Procedure is assigned ultrasound diagnostics with a vaginal probe, if there is a suspicion that the pregnancy does not develop or its development does not proceed correctly, it is slowed down. But for the procedure, the gestational age must be at least five weeks. Transvaginal ultrasound will allow you to see the fetal heartbeat, or rather, contractions of the heart muscle, which first begin from the third week of pregnancy. At earlier stages of pregnancy, vaginal ultrasound is not prescribed for these purposes, since there will be no movements.

Rules for the procedure

In order for transvaginal ultrasound to be as informative as possible, you need to properly prepare for it. It won't be too difficult. Transvaginal ultrasound is performed only for women living an intimate life. For girls who have not had sexual intimacy, the procedure is not performed due to the risk of damage to the hymen.

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For them, ultrasound diagnostics is used using a transabdominal sensor, i.e., the study of the structure and pathologies of the pelvic organs in the usual mode, when the sensor moves along the abdomen. There are cases when excessive fat deposits in the abdomen or excessive bloating of the intestines do not allow the full implementation of this procedure. Then, girls who do not live sexually are assigned transrectal ultrasound, i.e. a special sensor is inserted into the rectum.

Vaginal ultrasound does not require special preparation, but there are a number of recommendations and wishes that should be followed. Unlike classical (abdominal) ultrasound diagnostics, the bladder must be empty. If last hike the toilet was more than an hour ago, the ultrasound specialist will ask the patient to go to the toilet and empty the bladder. Very important point- intestinal flatulence. It is very important to make every effort to eliminate or reduce it. They will come to the rescue medical preparations aimed at reducing the concentration of gases in the intestines. The doctor who prescribes the procedure will help determine their choice and dosage.

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Therefore, it is very important to inform the doctor about this problem, if it is present. The next step is personal hygiene. It is very important to thoroughly wash the external genitalia and put on clean underwear before the procedure. If you need to go to the toilet before the procedure, do not forget to use wet sanitary napkins. This has no effect on the results, but, from an aesthetic point of view, this moment very important. If a vaginal examination is first performed abdominal diagnostics, then you need to come with a filled bladder and go to the toilet before using the vaginal probe.

Vaginal ultrasound is performed on specific days of the menstrual cycle. Within a month, a woman undergoes various changes in the structure of the internal genital organs, and in order to obtain the most accurate data on her state of health, you need to correctly correlate the day of menstruation and the problem that you want to detect or exclude. On the 12-14th day of the menstrual cycle, most women ovulate - a mature egg leaves the ovary and begins to move towards the uterine cavity.

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At this moment, all internal reproductive system a woman begins to change - she is preparing for the fertilization of the egg, its attachment to the walls of the uterus and development in the womb of the future fetus. How scheduled study, a transvaginal examination is performed as soon as menstruation stops. Usually this is day 5-7 of the cycle. If the menstrual cycle is set, and the woman knows exactly its approximate middle, a vaginal ultrasound can also be performed on days 8-12, but strictly before the onset of ovulation. In the event that a specialist suspects uterine endometriosis in a woman, a transvaginal examination is performed after ovulation. A procedure such as folliculometry, i.e. tracking the dynamics of maturation and development of follicles, is carried out three times over the entire period of the menstrual cycle. Usually it is 8-10 days, 14-16 and 22-24 days of the cycle. This procedure is also carried out as part of the treatment and preparation for the conception of a baby. If a woman has bloody or spotting discharge from the vagina in the middle of the cycle, that is, not associated with menstruation, a transvaginal examination is performed on any day. It is advisable to carry out this procedure immediately, as soon as unpleasant symptoms occur.

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During the period of expectation of a child, transvaginal diagnosis is carried out only in the first trimester of pregnancy. For more later dates the procedure is not performed due to the risk of miscarriage or premature birth. But sometimes a specialist may prescribe this study if possible benefit for the mother outweighs the threat to the fetus or abdominal examination does not give a complete picture of the developmental status of the baby ( excess weight mothers, flatulence, etc.). A classic study of the abdominal wall can be performed on any day of the menstrual cycle, except for the days of the vaginal bleeding itself. If the main task of ultrasound diagnostics is to clarify the preliminary diagnosis, then, according to the doctor's prescription, transvaginal diagnostics is carried out on any day of the menstrual cycle.

Transvaginal diagnosis is absolutely painless. In the ultrasound room, the patient should take off her clothes below the waist and lie on her back. Legs should be bent at the knees and spread out to the side. A special condom is put on the transvaginal sensor, which is lubricated with gel for the ultrasound procedure.

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This gel performs two functions - it acts as a lubricant - a lubricant that facilitates the maintenance of the probe, and helps in the conduction of ultrasonic waves. Outwardly, the sensor looks like a small rod, its diameter is no more than three centimeters, and its length is 12–14 cm. The sensor also has a beveled handle and a small channel into which, if necessary, a biopsy needle is inserted. The depth of insertion of the sensor is quite small, which makes the procedure painless. During the examination, the doctor can move the transducer from side to side, or up or down. If during such movements the patient feels pain or discomfort, this should definitely be reported to the diagnostician.

Decryption of received data

Ultrasound diagnostics, performed using a vaginal sensor, allows a more detailed and accurate assessment of the condition of the internal genital organs of a woman. During the procedure, the following organs and their parameters are examined:

the uterus and its cervix, including contours, dimensions and location in the pelvis;
structure of the epithelium of the uterus;
ovaries, their size, structure and location in the pelvis;
the junction of the ovary and fallopian tube;
follicles in the appendages (their size, quantity and quality).

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It is impossible to examine the fallopian tubes without the introduction of a special contrast fluid into them. Therefore, if the task of the procedure is to assess the condition of the fallopian tubes, a contrast solution is introduced. The amount of free fluid present in the lower abdomen is also studied.

The first indicator that is evaluated during the procedure is the echo picture of the internal genital organs. Normally, the uterus should have a slight forward tilt, this position is called anteflexio. With retroflexio, there is no such slope, which can interfere not only with the onset of pregnancy, but provoke the attachment of the fetal egg to the walls of the fallopian tubes, that is, an ectopic pregnancy. The next consequence of this position of the uterus is constant constipation, which occurs due to the displacement of the correct position of the intestine.

Normal contours of the uterus should be clear, even. Any deviations in these parameters indicate the presence of inflammatory processes both in the organ itself and in the tissues around it. The absence of clear contours can be a sign of the presence of a neoplasm, both benign and malignant.

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The correct dimensions of the uterus should be 7 cm long, 6 cm wide and 4.0-4.2 cm in diameter. If the size of the uterus is smaller, it is customary to speak of a "childish" or "infantile" uterus. If exceeded, we can talk about the onset of pregnancy or the presence of formations (cancer, fibroids, etc.).

The next parameter is echogenicity. Her normal condition- uniform. With heterogeneity, the presence of tumors or other neoplasms can be assumed. The thickness of the endometrial coating depends on the day of the cycle on which the ultrasound is performed. The closer the onset of menstruation, the thicker the layer of the endometrium on the walls of the uterus. If during the examination the specialist speaks of decidualization of the endometrial coating, this is a sign of a developing pregnancy.

The very structure of the internal organs should be uniform, with even and clear edges. When polyps, fibroids, cancerous and other neoplasms are found, the specialist refers to them as "hyperechoic formations".

Other components of the internal genital organs should be just as even and clear. Normally, a small amount of free fluid is allowed in the uterine cavity, mucus in the cervical canal.

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The fallopian tubes should not be visible, but their slightly noticeable presence is allowed. Any other deviations from the norm indicate the presence of inflammation, pregnancy and neoplasms of a different nature.

Ultrasound of the pelvic organs- a diagnostic method that displays the structure of the uterus, fallopian tubes, ovaries and cervix. Detects hyperplasia and cancer of the uterus, endometriosis, ectopic pregnancy, polycystic ovaries. When conducting a standard ultrasound, a two-dimensional mode is used. The study is performed by transabdominal, transvaginal and combined methods. The cost is determined by the technique of the procedure, the presence of dopplerography, 3D ultrasound.

Preparation

Before ultrasound of the pelvic organs, it is necessary to carry out preparatory measures, due to which the quality of visualization improves. The preparation plan includes individual recommendations from the doctor (cancellation of medications taken, the appointment of laxatives, carminatives), as well as general rules:

Power correction. 2-3 days before the study, you should stop eating foods that increase the content of gases in the intestines. Drinks with gas, peas, beans, muffins, cabbage, apples, milk should be excluded.
Compliance with the drinking regime. With transabdominal ultrasound, 40-60 minutes before the start of the diagnosis, you need to drink about a liter of water, juice or tea. This creates an "acoustic window" – A water-filled bladder better reflects ultrasound waves.

What shows

Ultrasound of the pelvic organs in women is performed using a transabdominal and transvaginal sensor, allows you to visualize the walls and cavity of the uterus, cervix, vagina, fallopian tubes, appendages and bladder. Dopplerography displays the nature of blood circulation and the functionality of the uterine and ovarian arteries. Normally, the length and width of the uterus are from 4 to 6 cm, the anteroposterior size is 2.7-4.9 cm. The myometrium is homogeneous, without inclusions. The width and length of the ovaries are from 2.3 to 4 cm, the volume is 1.5-2.5 cm, the echo structure is homogeneous, the contour is clear and uneven. Ultrasound results reveal various diseases, including:

Congenital anomalies of the uterus. Ultrasonic method reveals different types abnormal development uterus. On the ultrasound picture of the uterus irregular shape, completely or partially divided in two, curved, two-cavity. Depending on the nature of the changes, a bicornuate or unicornuate uterus, doubling of the organ, and the presence of a septum are diagnosed.
Endometriosis. With endometriosis, the spread of the internal mucous membrane beyond the uterine cavity, thickening of the walls and an increase in the size of the uterus is determined. Perhaps the presence of cysts in the ovaries - hypoechoic foci.
Myoma of the uterus. The main symptom of uterine fibroids is a myomatous node or nodes - foci of altered echogenicity. With the development of necrotic processes inside the tumor, echo-negative zones are observed. The organ cavity is deformed.
Ectopic pregnancy. The most common variant of ectopic pregnancy is tubal pregnancy, in which the fetus is detected in the lumen fallopian tube as a focus of increased echogenicity with increased blood circulation. The size of the uterus is enlarged, the endometrium is thickened.
Cancer of the body of the uterus. Small malignant uterine tumor increased echogenicity, homogeneous structure. With infiltrative growth of the neoplasm, the contour is uneven. For large and medium neoplasia, the heterogeneity of the internal structure, high echogenicity, and the absence of clear contours are characteristic.
Ovarian cysts. Simple cystic ovarian masses appear as anechoic foci without inclusions larger than 30 mm. Hemorrhagic cysts have hyperechoic inclusions, multiple thecalutein cysts, differ in greater wall thickness. In PCOS, the ovaries are enlarged medulla expanded, capsule of high echogenicity, on the periphery - anechoic areas. cysts corpus luteum- anechoic formations with thick walls.
Ovarian cancer. echo signs malignant neoplasms ovaries - anechoic, rarely hypoechoic lesions, irregular or rounded, with clear contours. Often, single or multiple septa of various thicknesses, echogenic inclusions are found along the internal capsule of the neoplasm and on the septa.

When making a diagnosis, the results of ultrasound examination are not used in isolation. To confirm the presence of the disease, the doctor analyzes the information obtained during the survey, gynecological examination, laboratory research blood and biopsy material.

Advantages

Ultrasound is highly accurate and informative data, harmless, provides information about up to date reproductive organs, allows you to detect diseases at an early stage. The disadvantages of the study include discomfort during the transvaginal procedure, in individual cases- the impossibility of differentiating the type of neoplasm. Ultrasound has a low cost compared to other imaging modalities such as CT and MRI.

Modern gynecology has several very precise and safe methods research. One of them is transvaginal ultrasound. Unfortunately, women are not sufficiently informed about its features, they do not know how to prepare for a vaginal ultrasound, some are prejudiced about the procedure. Consider what is and how transvaginal ultrasound is done, what results can be obtained by this method.

Features of the procedure

Transvaginal ultrasound (TV) is essentially no different from traditional sonography. The tissues are exposed to ultrasonic waves. They "reflect" from objects with different densities and are fixed by a special receiver, which transforms them into an image. The fewer layers the waves will overcome to the object under study, the less distortion the “picture” on the monitor will have.

Methods of gynecological ultrasound examination

Ultrasound with a vaginal probe, which is placed directly into the vagina, allows you to minimize the distance to the organs under study. The main advantage of the method over the traditional transabdominal (through the abdominal wall) examination is obtaining a better and clearer image. The study of the pelvic organs transvaginally allows you to diagnose the most minor deviations from the normal structure of tissues.

Indications

Ultrasound of the small pelvis with a transvaginal sensor allows you to identify diseases that have not yet shown themselves to be deployed clinical picture. This expands the possibilities early diagnosis in gynecology and urology. The indications are:

Pain in the lower abdomen of any intensity, which, in combination with other symptoms, makes it possible to suspect diseases of the pelvic organs.
pathology associated with menstrual cycle: heavy bleeding, irregular, excessively painful and prolonged menstruation.
The appearance of bleeding in the middle of the cycle.
Discomfort and pain in the lower abdomen during intercourse.
Diagnosis of the causes of infertility in women (one of the few methods that visually assesses the patency of the fallopian tubes).

Lower abdominal pain -
indication for a complete gynecological examination

To control artificial insemination.
Indications for combined with transabdominal ultrasound are suspicions of tumor changes. This is especially important for the early diagnosis of neoplasms in the ovaries, when surgical treatment not only saves the patient's life, but also gives her a chance to become a mother.
If an ectopic pregnancy is suspected, moreover, vaginal ultrasound can determine with great certainty the localization of the attachment of the fetal egg.
Control for various methods contraception: spiral, vaginal ring. At long-term use hormonal contraceptives study of their impact on .
Diseases of other pelvic organs: cystitis, urethritis. Elucidation of the organic causes of enuresis.

The advantage of the procedure is the safety for the woman's health (however, as with conventional sonography). Ultrasound examination can be done as many times as necessary in each case.

What diseases are determined using TV ultrasound

What does the study show? This question, of course, is of more interest to professional gynecologists and urologists.

We will give a list of the main pathologies to show how important and informative vaginal ultrasound is:

The tumor process is both malignant and benign (uterine fibroids, ovarian cancer, chorionepithelioma).
Pathology of pregnancy (cystic drift, ectopic pregnancy).
Diseases of the ovaries and fallopian tubes (polycystic, ovarian cyst rupture, fluid in the tubes).
Deviations in the structure of the inner layer of the uterus (endometrial polyposis) or its spread to neighboring organs (endometriosis).
The presence of fluid in the pelvis or lower abdomen.

The study is carried out (the number and quality of maturing follicles are assessed) and, since it allows you to detect a fetal egg of minimal size.

Transvaginal ultrasound during pregnancy

Many women ask the question is it possible to do a transvaginal ultrasound during pregnancy? It seems to them that the procedure carried out through the vagina can harm the development of the child. In fact, the method is absolutely safe.

Gynecological room for ultrasound diagnostics

6 arguments to do transvaginal ultrasound during pregnancy:

Diagnosis of pregnancy with ultrasound in the early stages. Sometimes, when examining through the abdominal wall, the doctor doubts the location of the fetal egg in the uterus. Then an additional ultrasound is done through the vagina, which is a more sensitive method.
Definition multiple pregnancy. In the early stages, only with the help of transvaginal ultrasound can two or more embryos be seen in the uterus.
This is an indispensable way to detect ectopic pregnancy, and, most importantly, the place of atypical attachment of the fetal egg. If such a diagnosis is carried out on time, then surgical intervention to remove the embryo will minimally injure the tissues and preserve the woman's ability to conceive in the future.
In combination with Doppler sonography, it allows to detect the very first signs of pathology of the nervous and vascular system fetus. This is important for early (in the 1st trimester) diagnosis of malformations and genetic diseases child.
Getting over reliable information about the state of the endometrium and the thickness of the chorion (the place from which the placenta is subsequently formed), early detection miscarriage symptoms. This allows you to take timely measures and save the pregnancy.
The study is safe and does not cause discomfort.

It should be noted that transvaginal ultrasound is performed only in the 1st trimester of pregnancy. In the future, the fetus is examined using the usual transabdominal method.

How is the procedure carried out

In order to dispel all doubts about the safety and comfort of this research method, we will describe in detail how a vaginal ultrasound is done.

The woman will have to undress to the waist and sit on the couch in a pose that is traditional for any gynecological examination.
The transvaginal transducer, which is inserted into the vagina, is a tube 3 cm in diameter (12 cm long). Inside there is often a channel for the location of the biopsy needle.
For hygiene purposes, a disposable condom is put on the sensor before the study.
The vaginal probe is inserted at a shallow depth, so it usually does not cause discomfort. During the procedure, the doctor can move it a little, but this should not affect the sensations. Most of the women who underwent the procedure noted the complete absence of any unpleasant moments.

transvaginal sensor

Special preparation before conducting transvaginal ultrasound of the pelvic organs is not required. If the examination through the abdominal wall requires filling the bladder, which often causes discomfort in patients, then in this case the bladder should be empty.

Preparation for transvaginal ultrasound comes down to emptying the large intestine (sometimes you need to give an enema for this) and combating excess gas formation. Before the procedure, some foods should be limited: dairy, vegetables and fruits, sweets, soda, mushrooms, fried foods. You can additionally take medicines to combat flatulence (Espumizan).

Some patients ask whether it is possible to have sex before the procedure. They are accustomed to the fact that such restrictions are appropriate when taking vaginal swabs. In this case, sex does not affect the results of the ultrasound.

Optimal timing of the procedure

When is the best time to do a transvaginal ultrasound? The answer to this question is better to learn from the attending physician, depending on the specific goals of the study. We will outline a few common features.

Timing of TVUS for suspected certain diseases:

Endometriosis can be confirmed by ultrasound in the second half of the cycle.
In preparation for conception or determining the causes of infertility, a study of the follicles in dynamics is carried out. What day of the cycle? Better three times - 8-10 days, 15-16 and after 22 days of the cycle.
If a woman complains of bleeding outside of menstruation, then the diagnosis is not delayed, as this may be a sign of diseases requiring immediate treatment.

If the procedure is planned, then it, like abdominal ultrasound, is carried out immediately after the end of menstrual bleeding.

Interpretation of results

All women are interested in what can be seen with a transvaginal ultrasound. For convenience, we give some characteristics in the table ( click on table to enlarge).

How does the ultrasound picture change with various diseases You can always check with your gynecologist. The main thing is not to try to interpret the results on your own, since they differ greatly depending on the cyclicity of the processes occurring in the woman's body.

Transvaginal ultrasound is one of the most effective ways early diagnosis in gynecology. Its safety has been confirmed even in pregnant women.