Transvaginal ultrasound: all about the wonderful method. How transvaginal ultrasound allows you to examine the female pelvic organs

Why do some patients need to drink a certain amount of fluid before this diagnostic procedure? What conclusions can doctors draw from the results of this study? The reader will find answers to these questions in our article.

The first ultrasound: how and why?

The ultrasound method is based on the principle of echolocation. A special sensor emits ultrasonic waves, which, passing through tissues and organs, are reflected from them, returned and perceived by the sensor. Organs of different densities reflect ultrasonic waves in different ways and “deliver” different response signals to the sensor. After the “brain” of the apparatus processes the information received, an image of a certain section of the organ under study (or the fetus during pregnancy) appears on the screen.

With the help of echography, in most cases it is possible to obtain sufficient information about the condition of the patient and the fetus.

The advantages of this method are:

* high information content;
* relative simplicity and speed of research;
* high level of security;
* no need for special preparation of the patient;
* the possibility of conducting repeated studies in order to monitor the nature of the course of pregnancy, the development of the fetus, or to monitor the effectiveness of the therapy.

Ultrasound has been used for diagnostic purposes for more than 40 years. During this period, no adverse effects of this diagnostic method on the fetus were identified. The ultrasonic sensor is in the radiation mode for no more than 0.1% of the study time, and the rest of the time it receives ultrasonic waves reflected from the object. Therefore, the method is quite harmless not only for a woman, but also for her unborn child.

Currently, two main ultrasound techniques are widely used in obstetrics: examination through the abdominal wall and examination using a vaginal probe (transvaginal method).

Ultrasonic waves pass freely through the liquid, which is a kind of window for them. When examining the pelvic organs of non-pregnant women and short-term pregnant women, the role of such a window is played by a filled bladder. That is why the patient should drink 500-700 ml of liquid approximately 1.5 hours before the procedure1. With an increase in the gestational age, the volume of amniotic fluid increases, which, surrounding the fetus, makes it available for ultrasound. Thus, the need to fill the bladder gradually disappears.

Transvaginal ultrasound

In recent years, in many cases, a transvaginal method has been used, in which a special sensor is inserted into the vagina with a condom put on it for hygienic purposes. Due to the closer location of the internal organs, they are better viewed, which increases the accuracy of diagnosis. In addition, with this study, there is no need to fill the bladder. However, the transvaginal ultrasound method is not recommended for the earliest stages of pregnancy, such as 5-7 weeks. The optimal time for transvaginal ultrasound is the 9th week of pregnancy.

In the normal course of pregnancy and the absence of additional indications, three planned ultrasound examinations are sufficient (one in each trimester: at a period of 10-14 weeks, 20-24 weeks and 36-38 weeks).

What can be the reason for an ultrasound for up to 10-12 weeks of pregnancy?

If there are indications, ultrasound diagnostics can be performed at any (including the earliest) stages of pregnancy, and more than once.

In the first trimester of pregnancy, an ultrasound may be prescribed to clarify the gestational age if the patient has an irregular menstrual cycle.

In addition, for periods up to 10-12 weeks, a study is prescribed if the following pathological conditions are suspected in a woman:

* the threat of miscarriage and the presence of increased uterine tone, which are manifested by pain in the lower abdomen, bloody discharge from the genital tract;
* non-developing or missed pregnancy (with the help of ultrasound, the absence of a heartbeat and motor activity in the embryo will be revealed), other pathological conditions (for example, cystic drift); the presence of an ectopic pregnancy;
* the presence of tumors and tumor-like formations of the uterus (myoma, endometriosis) and appendages (cysts and tumors of the ovaries);
* anomalies in the development of the genital organs (for example, doubling of the uterus, the presence of a septum in the uterus, etc.).

Diagnosis of a number of diseases allows you to provide emergency care to the patient and avoid serious complications in the future.

It is very important that with the help of ultrasound it is possible to diagnose multiple pregnancies.

What and when is “seen” on ultrasound

Currently, with the help of transvaginal ultrasound, the presence of uterine pregnancy can be established already with a delay of menstruation by 4-5 days, i.e. with a true, or embryological, gestational age of 2-5 weeks (after 4-5 weeks from the first day of the last menstruation) . At this time, the diameter of the fetal egg is about 5 mm.

At the earliest stage, a fetal egg with a diameter of several millimeters is found in the uterine cavity. Later, the gestational age is determined by measuring the tip-parietal size of the embryo (in this case, the maximum distance from its head end to the coccyx is determined). The results obtained are compared with the existing normative indicators. In this case, the error usually does not exceed 3 days. At the gestational age of 3 weeks, the embryo is determined, at the same time, the heart pulsation is also most often visible. At this time, the coccyx-parietal size of the embryo is about 4 mm. Its head becomes visible on the monitor screen from the 7th week of pregnancy, the limbs - from the 8th week, and the bones in them - after the appearance of ossification points (at 9-11 weeks).

With a period of 11-14 weeks, you can also see the number of fingers, which allows you to diagnose a number of pathological syndromes. Visualization of the stomach and bladder of the fetus with transvaginal echography is possible in almost all cases by the 11-12th week of pregnancy, and the kidneys - from 12 to 13 weeks of gestation.

Gender testing in the first trimester is not usually done, and you will most likely be able to get the first information on this issue for a period of about 15-16 weeks (in some cases it is possible, using the latest equipment, to try to establish the floor a little earlier). But a more accurate sex determination is possible only at a later date - 22-25 weeks.

Thus, most of the organs and systems of the fetus become visible after the 11-12-week gestation period. However, before the 12-14-week period, using ultrasound, only gross malformations can be detected (this can be a reason for artificial termination of pregnancy), and it is impossible to reliably assess the detailed anatomy of the fetus: at this time, one can only suspect some minor birth defects in the fetus In the future, to clarify the situation, repeated ultrasound and additional research methods are performed.

In the last decade, more and more often during ultrasound, the so-called “collar space” is measured (normally it is 2-3 mm). Doctors have noticed that the presence of an “edematous” (more than 3 mm) zone in the neck of the fetus is often combined with various chromosomal disorders. This symptom is typical for the first trimester of pregnancy, so the measurement of the thickness of the "collar space" is made at a period of 10 - 14 weeks. This indicator allows, when conducting an ultrasound examination, to distinguish among pregnant women a risk group for the birth of children with hereditary pathology. These pregnant women should undergo regular additional examinations in specialized institutions (preferably prenatal diagnostic laboratories).

What you need to know about the first ultrasound?

In conclusion, it should be noted that ultrasound should not become a method for diagnosing pregnancy: the very fact of pregnancy can be established using simpler and cheaper methods. In addition, despite the safety of ultrasound, in early pregnancy it is advisable to carry it out only when necessary. Modern medicine does not have data that the intensity of ultrasound exposure currently used in diagnostic devices can cause any harm to the fetus and mother. However, you should still avoid repeated studies conducted without a doctor's prescription.

Referring the patient to an ultrasound scan, the doctor must provide the ultrasound diagnostic specialist with information about the indications for this study orally or in writing. The fact is that the usual planned examination is carried out quickly and not always thoroughly, so the probability of detecting some anomalies in the development of the fetus may be less than with a targeted examination, when these defects are supposed to be searched. If a particular pathology is detected, especially requiring termination of pregnancy, it is recommended to re-examine, preferably in a prenatal laboratory.

It is very important that the patient saves the results of the ultrasound examinations. This will allow the doctor to assess the nature of the course of pregnancy, the dynamics of fetal development, as well as timely identify emerging complications.

1. Before an ultrasound, consult your doctor about how much fluid to drink and whether you need to drink at all.

2. Severe disease, manifested by the growth of chorion tissue. The embryo is initially absent or dies at the very beginning of pregnancy.

3. It should be remembered that in the event of medical “renderings to determine the sex of the fetus (if a sex-related congenital pathology is suspected), a number of complex additional studies (examination of amniotic fluid, chorionic biopsy) are performed in prenatal laboratories.

A vaginal ultrasound (transvaginal ultrasound) is a procedure performed to examine the condition of the pelvic organs in women. This diagnostic method 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 of 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 a 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 that is 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 of the ovaries;
• endometriosis of the uterus;
• pregnancy (uterine and ectopic);
• the presence of fluid, pus or blood in the fallopian tubes, which causes the presence of inflammatory processes in them (without differentiation of these fluids);
• 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 determine 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. An ultrasound diagnostic procedure with a vaginal probe is prescribed if there is a suspicion that the pregnancy is not developing or its development is not going well, 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.

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 the last trip to the toilet was more than an hour ago, the ultrasound specialist will ask the patient to go to the toilet and empty the bladder. A very important point is intestinal flatulence. It is very important to make every effort to eliminate or reduce it. Medications will come to the rescue, 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 is very important. If an abdominal examination is performed first before the vaginal examination, then you need to come with a full 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, the entire internal reproductive system of 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. As a routine study, a transvaginal study 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. At a later date, the procedure is not performed due to the risk of miscarriage or premature birth. But sometimes a specialist may prescribe this study if the possible benefit to the mother outweighs the threat to the fetus or the abdominal examination does not give a complete picture of the state of development of the baby (excess weight of the mother, 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 state is homogeneous. 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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Recently I went to my old friend, it turned out that she was prescribed a transvaginal ultrasound for the first time, as she complained of pain in the lower abdomen. Before I had time to undress, she bombarded me with questions - “does it hurt, but how do they do it, and how to prepare?” etc.

I thought that among my readers there are many who are prescribed a transvaginal ultrasound for the first time and they are asking the same questions.

If you just have to undergo an examination, then read the article. In it, I tried to tell in detail about the indications for the conduct, preparation and the procedure itself.

• irregular periods or their absence;
• the appearance of selections outside the cycle;
• pain in the lower abdomen;
• suspected ectopic pregnancy;
• severe menstrual pain;
• diseases of the mammary glands;
• hormonal disorders;
• suspicion of an inflammatory process in the ovaries or uterus;
• infectious diseases of the urinary tract;
• suspicion of a neoplasm during a gynecological examination;
• monitoring the results of therapy for an existing disease (acute or chronic);
• preventive diagnostics to prevent the occurrence of diseases (screening);
• preparation for the IVF procedure;
• determining the location of the intrauterine device;
• diagnosis of pregnancy and fetal development (in the early stages).

Preparing for a transvaginal ultrasound procedure

There are no contraindications to the use of transvaginal ultrasound, but there are some limitations:

• examination of pregnant women with a transvaginal sensor is recommended only in the early stages. This is due to the fact that determining the condition of the fetus at the beginning of pregnancy through the abdominal wall may be ineffective, in contrast to transvaginal, which allows accurate diagnosis of the fetus;
• transvaginal ultrasound to a virgin cannot be done through the vagina. For such patients, there are alternative methods of ultrasound - transabdominal and transrectal.

Special preparation for this type of study is not required, however, experts recommend refraining from sex for a day before an ultrasound scan, just like before any other gynecological procedure.

Dependence of the results of the study on the day of the menstrual cycle

Ultrasound must be done strictly on certain days of the female cycle.

• The optimal time for the study is 5-7 days from the onset of menstruation. During this period, the maximum accuracy of assessing the state of the reproductive organs and diagnosing the presence or absence of pathological changes is possible.
• If the study is prescribed by a gynecologist to monitor reproductive function, monitor ovulation, or identify the causes of a hormonal disorder, the doctor informs the recommended day for it.

How is a transvaginal ultrasound done?

Transvaginal ultrasound is a completely safe and painless procedure, much more comfortable than a gynecological examination.

Having undressed below the waist, the patient lies down on the couch, bending her legs at the knees and slightly lifting them up, for the convenience of inserting the sensor. A special hygienic condom is put on the sensor, which ensures the sterility of the examination.

The diameter of the device - 2.5-2.8 cm in diameter - corresponds to the physiological structure of the female body, and a special gel facilitates its penetration.

During the diagnosis, the specialist slightly shifts the sensor, examining the uterus and adjacent organs.

If it is necessary to provide better access to the area being examined, the doctor may ask you to slightly change the position for a more effective position of the device.

The information transmitted by the vaginal sensor is displayed on the monitor of the ultrasound machine in different projections, and zooming allows you to enlarge the image and examine the tissue fragment of interest in detail.

The study lasts no more than 20 minutes. Upon completion, the specialist prints the received images and records the ultrasound data in writing.

Results of a transvaginal examination: assessment and analysis

A qualified doctor, having received the results of ultrasound diagnostics, is able to quickly establish an accurate diagnosis and choose the optimal and effective method of subsequent therapy.

During the survey, the following indicators are evaluated:

Position and size of the uterus. In most women, the uterus has a slight inclination in front - this is the absolute norm. Sometimes there is a deviation of the uterus back, or "bend of the uterus", which is conventionally considered to be a deviation from the norm. This situation can prevent the onset of a long-awaited pregnancy and requires individual recommendations from a gynecologist.

The size of the uterus depends on the age of the woman, the number of pregnancies and childbirth, and the individual anatomical features of the body. Normally, the size of the uterus is about 70x60x50 mm (in women who have given birth), 50x50x45 mm (in nulliparous women). A significant increase in size requires observation - as a rule, this indicates a pathological condition.

With the development of fibroids - a benign tumor that develops from muscle tissue - surgery or long-term drug treatment with constant monitoring is required. A decrease in the size of the uterus is relatively rare and indicates an anomaly of underdevelopment of this organ.

The thickness of the inner layer of the uterus. The inner layer of the uterus - the endometrium - has different norms, depending on the phase of the monthly cycle. In the first phase, corresponding to 3-4 days of the cycle, the endometrium is restored after menstruation, and by 5-7 days (the beginning of the second phase) it reaches 3-6 mm.

In the middle of the cycle, during ovulation, the thickness of the layer grows to 10–15 mm, gradually increasing to 12–20 mm by the beginning of menstruation. The condition of the epithelial layer should correspond to the day of the study, otherwise the development of inflammation can be suspected.

The structure of the uterus or its echogenicity(walls and cavities). In a healthy woman, the structure is homogeneous, the uterus has even, clear boundaries. Hyperechoic inclusions recorded during observation indicate the presence of neoplasms.

Cervix. Normally, the cervix has a size of up to 40x30 mm, has a homogeneous structure. Endocervix - the cervical canal - is filled with mucus (homogeneous liquid) and no more than 3 mm in diameter.

The presence of free fluid in the pelvis. A small amount of fluid in the pelvis in a healthy woman is observed after ovulation, i.e. rupture of the follicle. On other days, there should be no free fluid - such a “find” may indicate inflammation of the ovaries due to an infectious disease.

Dimensions and contours of the ovaries. The normal size of the ovaries in women is up to 37x30x22 mm, the left and right may vary slightly. The volume of the ovaries should not exceed 10 cm3.

Increased sizes can be not only an individual anatomical feature, but also a sign of inflammation or the development of a polycystic syndrome. The contours of healthy ovaries are clear, well visualized and uneven due to the formation of follicles.

Fallopian tubes. On ultrasound, the tubes are determined more often in the presence of pathological changes - inflammation or ectopic pregnancy. To monitor the condition of the fallopian tubes, ultrasound can be used with the introduction of a contrast agent, which allows you to assess their patency.

The most common diseases diagnosed by ultrasound

• Inflammation of the ovaries (oophoritis) - an increase in the size and volume of the appendages, the lack of clarity of contours, the presence of fluid in the small pelvis is possible.
• Inflammation of the fallopian tubes (salpingitis) - visualization of the tubes, thickening of their walls.
• Inflammation of the endometrium of the uterus (endometritis) - an increase in the size of the uterus and the inner layer.
• Polycystic ovaries - the presence of multiple immature follicles, the excess of normal ovarian volumes.
• Uterine fibroids - an increase in the size of the uterus, a violation of the contour, the presence of a hyperechoic area.
• Polyps of the uterus - "protrusions" of sections of the endometrium into the uterine cavity, are defined as volumetric formations, single or multiple.
• Endometriosis of the uterus - an increase in the size of the uterus, asymmetry in the thickness of its walls, uneven endometrium.
• An ovarian cyst is a fluid-filled formation larger than 28–30 mm.
• Cervical cancer is a change in the size and shape of the cervix.
• Ovarian cancer is a significant increase in the size and deformation of the contours of one ovary.
• Uterine cancer - manifested by violations of the structure and contours of the organ.

In most cases, these diseases require medication or surgery, and only a doctor can make an accurate diagnosis based on the examination. Even the presence of any anomalies in the contours of the organ and volumetric formations does not indicate their malignant nature.

Follicular ovarian cysts, for example, can reach sizes of 5-7 cm in diameter, disappearing after a few cycles under the supervision of a doctor without surgical intervention.

However, women of any age need to visit a gynecologist regularly. Only timely diagnosis, attention to one's own body and a reasonable attitude to treatment is the guarantor of women's health.

I hope my article has helped allay your fears regarding transvaginal ultrasound. If you have any questions feel free to ask them in the comments below.

Transvaginal ultrasound is one of the most accurate types of ultrasound that can be used to diagnose the female pelvic organs. Often, transvaginal ultrasound is performed in combination with transabdominal. For any ultrasound, sensors are usually placed on the skin closer to the organ being studied.

How is the diagnosis done?

When it comes to diagnosing the female genital organs, then we can say that it is carried out

Abdominal (through the abdomen) and vaginal (through the vagina) examination. With the help of a transvaginal examination, you can more clearly examine the internal organs and identify any changes.

Diagnosis of the internal female genital organs takes place in two stages.

1. The first of these is a transabdominal examination.
2. After that, a transvaginal is performed. When carrying out the procedure transvaginally, the uterus with appendages is better visualized.

Using this research method, doctors can diagnose diseases of the pelvic organs in the early stages. Just at the moment when any changes have not yet occurred.

There are times when transvaginal ultrasound alone is not enough to make a correct diagnosis. Then more research can be done. One of these may be, for example, colposcopy of the cervix.

It is thanks to the early detection of problematic pelvic organs that it is possible to start the necessary treatment in a timely manner. It also helps prevent all sorts of complications.

For example, with the timely surgical removal of a benign tumor, a complication in the form of malignancy of the neoplasms can be prevented. This poses a danger primarily to the life and health of the female body.

When is a transvaginal ultrasound indicated?

Indications for the appointment of transvaginal pelvic ultrasound may be as follows:

• Diagnosis of the length of the cervix.
• The study of the functioning of the ovaries with the definition of their shape (indicated for female infertility).
• To determine the anatomical structure of the uterus, namely: to study its size, shape, condition and, directly, the thickness of the endometrium.
• For diagnosing cysts and neoplasms.
• For support: in case of surgical intervention of in vitro fertilization at the initial stage; at the moment the doctor extracts the egg and at the moment the female reproductive cell is placed back.
• To diagnose an ectopic pregnancy.
• To identify the cause of bleeding.
• To determine pregnancy.
• Excessive weight of the patient, when it is impossible to see the desired organ well through the abdominal cavity.

Contraindications

An absolute contraindication to transvaginal ultrasound is that the patient is a virgin. In this case, the ultrasound of the virgin will be performed abdominally. It is also possible to conduct an ultrasound transvaginal probe through the rectum.

Transvaginal ultrasound during menstruation

Many women are interested in the question of whether it is possible to do such an ultrasound during menstruation, and if not, on what day of the cycle is it already possible. The fact is that this ultrasound method does not depend on the phase of the cycle, so it is carried out depending on the degree of the disease. For example, when a patient is diagnosed with uterine fibroids, ultrasound should be performed in the first phase. And if you suspect endometriosis, in the second.

When is the best time to have an ultrasound during pregnancy?

This question interests many expectant mothers. The answer is the following, if the pregnancy proceeds without complications, then transvaginal ultrasound is performed in the first trimester of pregnancy, namely from 11 to 14 weeks. Starting from the 14th week, transabdominal diagnosis is carried out.

The method of preparation for this diagnosis does not require special conditions for carrying out. The procedure for ultrasound of the uterus and appendages occurs with the participation of a transvaginal sensor, and there is no need to fill the bladder before that.

However, during pregnancy, before a vaginal ultrasound, a woman needs to drink about 1 liter of water, about an hour before the procedure, since ultrasound is not performed on an empty bladder in this case.

Also, another important factor before conducting such an ultrasound is the absence of gases in the intestines. Therefore, if you are wondering if you can eat before the procedure, the answer will be that you can eat.

But a few days before the procedure, it is necessary to exclude those products that contribute to the occurrence and increase of gas formation (sour-milk products, bread, confectionery and flour products). If there is an increase in flatulence, then the doctor recommends taking coal and Espumizan.

How is a transvaginal ultrasound done and how to prepare for it?

The diagnostic procedure is carried out in two stages. The first stage is considered to be preparation, and the second is the ultrasound itself. Preparation consists in the fact that the patient will need to undress, remove everything below the waist and lie on the couch, while bending her knees.

The ultrasound machine should already be turned on at this time. After that, the doctor should put a condom on the vaginal probe. You should be aware that transvaginal ultrasound without a condom is not performed. Since infection through an unprotected sensor is possible. After that, the doctor applies the gel to this sensor and begins to gently insert it into the vagina. From this moment, the second stage of the ultrasound begins.

This procedure is painless, and if you think about whether it hurts or not, it does not hurt, however, in acute inflammatory processes, it can cause slight discomfort and pain. After inserting the probe into the vagina, an image of the internal genital organs can be seen on the screen of the ultrasound machine.

Diagnosis occurs in the same way as the study of female organs (uterus, ovaries). Since this is a very serious disease and requires proper and timely treatment.

Varicose veins of the small pelvis provokes a violation of the blood circulation of the uterus and its appendages. As a result, the menstrual cycle is disturbed, there is constant pain in the lower abdomen, a woman can become infertile.

Discharge after the procedure can most often occur during pregnancy. Slightly pink discharge should not bother you, however, if such discharge appears frequently and in a copious form, talk to your doctor about it.

Deciphering ultrasound

All results of the ultrasound are recorded in a special protocol. This form is filled out during the procedure. The term "norm" refers to the normal state of the pelvic structures or the fetus.

Abnormal results may include:

1. birth defects;
2. ovarian or uterine cancer;
3. vaginal cancer;
4. cancer of other pelvic structures;
5. curvature of the ovaries;
6. infectious and inflammatory processes in the pelvic organs
7. neoplasm near the uterus and ovaries or, directly, in the uterus.

Possible risks

To date, no risks or negative effects on a person or fetus have been identified with transvaginal ultrasound. This is due to the fact that, unlike traditional x-rays, no radiation is used in this examination. Alternative names for this procedure may be: transvaginal ultrasound, Endovaginal ultrasound.

What price?

The cost of such a procedure, on average, in different cities of Russia is about 1000 rubles. The price in Moscow for a transvaginal ultrasound of the pelvic organs is about 1500 rubles. During pregnancy, the price depends on the type of study and ranges from 900 to 4000 rubles.

The approximate cost of such a procedure in Saratov is from 650 to 1000 rubles (during pregnancy from 750-1300).

• In Penza from 400 to 600 rubles. average.
• In Tyumen from 800 to 1200 rubles.
• In Chelyabinsk from 550 to 800 rubles.
• In Kirov from 800 to 900 rubles.
• In Omsk from 500 to 850 rubles.
• In Ufa from 500 to 900 rubles.

Question answer

Quite often, many women, upon learning that they need to undergo a transvaginal ultrasound, ask questions about what it is, what such a study shows and whether it hurts. Therefore, here are some frequently asked questions that can be answered:

• Is it dangerous to do a transvaginal ultrasound in late pregnancy?

Answer: No, it's not safe. During pregnancy, transvaginal pelvic ultrasound can be done as needed, if there is an indication for this. However, if you are very worried, you can ask for an ultrasound not transvaginally, but rectally, for example. Then the doctor will be able to examine everything he needs by inserting the sensor into the rectum.

• Is it harmful during pregnancy?

Answer: No, it's harmless. Since such an ultrasound examination, unlike conventional x-rays, does not carry any radiation.

• How long does a transvaginal ultrasound do?

Answer: Transvaginal ultrasound is done up to 12-14 weeks of pregnancy. However, there are cases when transvaginal ultrasound is indicated at a later date. The reason for this may be:

• the presence of a scar on the uterus during previous caesarean sections.
• placenta previa;
• suspicion of weakness of the cervix and its inability to hold the fetal bladder;
• the threat of miscarriage in the early stages and the threat of interruption, in the later;

• At what time is it done and when is it better to do a transvaginal ultrasound?

Answer: As a rule, transvaginal ultrasound is indicated for a period of 11-14 weeks without risk to the fetus and mother. Therefore, it is better to try a study for a period of 12 weeks.

• How often can a transvaginal exam be done?

Answer: You can do as many times as there are indications for this.

• Can I have sex before an ultrasound??

Answer: As a rule, you should abstain from sexual intercourse before a vaginal ultrasound for 72 hours before the procedure.

• What does control ultrasound mean??

Answer: Control ultrasound is an ultrasound examination in which the doctor examines only those places where problems were previously identified.

• Where to do this ultrasound?

Answer: Such an ultrasound can be done in a clinic or in a diagnostic center. Also in the cities of Russia, you can undergo a vaginal examination in the laboratory "Invitro".

Progress in the medical industry has made it possible to successfully cope with health problems and identify them at an early stage. This, in turn, is the key to the effectiveness of treatment and good health. The above applies to ultrasound diagnostic devices. Thanks to them, women today not only know exactly who will be born to them, but all 9 months are under reliable control.

Vaginal ultrasound has become a new stage in the development of ultrasound diagnostics. About him, his role for expectant mothers and will be discussed.

Ultrasound abilities

Modern ultrasound equipment allows you to examine the uterus, cervix, vagina, fallopian tubes, ovaries and bladder. Ultrasound with a vaginal probe has a number of advantages. First, it does not require bladder filling and is therefore more comfortable for patients. Secondly, such a sensor allows you to more clearly visualize the organs under study, so the quality of such diagnostics is much higher. In addition, the vaginal diagnoses pregnancy at an earlier date than usual. Everyone knows that such a procedure is absolutely safe for health. That is, such diagnostics is a fast, economical and comfortable method of examination and does not require special training.

Indications for vaginal ultrasound are the diagnosis of gynecological diseases and early pregnancy, monitoring its course, folliculometry, monitoring the state of the IUD and the condition of the woman after extraction. There are no contraindications to such an ultrasound, it can be performed on any day of the cycle.

During a vaginal ultrasound, a doctor can diagnose congenital anomalies of the uterus, endometriosis, fibromyoma or leiomyoma, hyperplasia, polyps, and malignant tumors. In the presence of these diseases, with the help of continuous research, it is possible to monitor the course of treatment, changes in the size of tumors or the final cure of patients.

In order to prevent vaginal ultrasound of the pelvic organs, women over 40 are recommended to do it once a year.

Vaginal ultrasound during pregnancy

Nowadays, ultrasound is a reliable and common way to examine a woman during pregnancy. Vaginal ultrasound diagnoses different types: tubal, cervical, ovarian.

If in the later stages, in most cases, an abdominal sensor is used (traditional ultrasound), then in the first trimester, preference is given to the transvaginal ultrasound technique. This technique most accurately displays an image of the uterus with a developing fetus on the monitor. Since pregnancy with such an ultrasound is visible much earlier, problems in the development of the embryo can be diagnosed at the earliest possible time.

By the way, for this procedure you must have a condom. It is put on the sensor purely for hygienic purposes. For this, any classic pharmacy condom is suitable.

So, what are the indications for a vaginal ultrasound for expectant mothers in the early stages?

1. Determination of the presence of pregnancy.
2. Monitoring the development of the fetus.
3. Diagnosis of the threat of gestation.
4. Assessment of the peritoneal space.
5. Diagnosis of uterine fibroids.

After the first trimester, the use of such an ultrasound is not very common. It is done to assess the condition of the cervix, the ability to hold the fetal bladder, the diagnosis of placenta previa, the assessment of the condition of the scar on the uterus after CS.

Pregnant women often wonder how harmless such an ultrasound is and how often it can be done. Transvaginal ultrasound is safe and there are no restrictions on the number of diagnostics performed in this way. As for the protection of the child in the uterus from the sensor, then there is nothing to worry about at all. The vaginal sensor does not reach the child and does not even come close to him. The ultrasonic wave is absolutely harmless to the fetus, and the benefits and possibilities of such a study are extremely significant.

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Especially for Elena TOLOCHIK