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Gynecologic ultrasonography or gynecologic sonography refers to the application of
medical ultrasonography Medical ultrasound includes diagnostic techniques (mainly imaging techniques) using ultrasound, as well as therapeutic applications of ultrasound. In diagnosis, it is used to create an image of internal body structures such as tendons, mus ...
to the female pelvic organs (specifically the
uterus The uterus (from Latin ''uterus'', plural ''uteri'') or womb () is the organ in the reproductive system of most female mammals, including humans that accommodates the embryonic and fetal development of one or more embryos until birth. The ...
, the
ovaries The ovary is an organ in the female reproductive system that produces an ovum. When released, this travels down the fallopian tube into the uterus, where it may become fertilized by a sperm. There is an ovary () found on each side of the body. T ...
, and the
fallopian tubes The fallopian tubes, also known as uterine tubes, oviducts or salpinges (singular salpinx), are paired tubes in the human female that stretch from the uterus to the ovaries. The fallopian tubes are part of the female reproductive system. In ot ...
) as well as the
bladder The urinary bladder, or simply bladder, is a hollow organ in humans and other vertebrates that stores urine from the kidneys before disposal by urination. In humans the bladder is a distensible organ that sits on the pelvic floor. Urine en ...
, the adnexa, and the
recto-uterine pouch The rectouterine pouch (recto-uterine pouch), pouch of Douglas, or rectovaginal pouch is the extension of the peritoneum between the rectum and the posterior wall of the uterus in the human female. Its anterior boundary is formed by the posterio ...
. The procedure may lead to other medically relevant findings in the pelvis.This technique is useful to detect myomas or mullerian malformations.


Routes

The examination can be performed by
transabdominal ultrasonography Abdominal ultrasonography (also called abdominal ultrasound imaging or abdominal sonography) is a form of medical ultrasonography (medical application of ultrasound technology) to visualise abdominal anatomical structures. It uses transmission a ...
, generally with a full bladder which acts as an acoustic window to achieve better visualization of pelvis organs, or by
transvaginal ultrasonography Vaginal ultrasonography is a medical ultrasonography that applies an ultrasound transducer (or "probe") in the vagina to visualize organs within the pelvic cavity. It is also called transvaginal ultrasonography because the ultrasound waves go ' ...
with a specifically designed vaginal transducer. Transvaginal imaging utilizes a higher frequency imaging, which gives better resolution of the ovaries, uterus and
endometrium The endometrium is the inner epithelial layer, along with its mucous membrane, of the mammalian uterus. It has a basal layer and a functional layer: the basal layer contains stem cells which regenerate the functional layer. The functional layer ...
(the fallopian tubes are generally not seen unless distended), but is limited to depth of image penetration, whereas larger lesions reaching into the abdomen are better seen transabdominally. Having a full bladder for the transabdominal portion of the exam is helpful because sound travels through fluid with less attenuation to better visualize the uterus and ovaries which lies posteriorly to the bladder. The procedure is by definition invasive when performed transvaginally. Scans are performed by health care professionals called sonographers, or gynecologists trained in ultrasound.


Applications

Gynecologic sonography is used extensively: * to assess pelvic organs, * to diagnose acute appendicitis * to diagnose and manage gynecologic problems including
endometriosis Endometriosis is a disease of the female reproductive system in which cells similar to those in the endometrium, the layer of tissue that normally covers the inside of the uterus, grow outside the uterus. Most often this is on the ovaries, fa ...
,
leiomyoma A leiomyoma, also known as a fibroid, is a benign smooth muscle tumor that very rarely becomes cancer (0.1%). They can occur in any organ, but the most common forms occur in the uterus, small bowel, and the esophagus. Polycythemia may occur due t ...
,
adenomyosis Adenomyosis is a medical condition characterized by the growth of cells that proliferate on the inside of the uterus ( endometrium) atypically located among the cells of the uterine wall ( myometrium), as a result, thickening of the uterus occurs. ...
, ovarian cysts and lesions, * to identify adnexal masses, including
ectopic pregnancy Ectopic pregnancy is a complication of pregnancy in which the embryo attaches outside the uterus. Signs and symptoms classically include abdominal pain and vaginal bleeding, but fewer than 50 percent of affected women have both of these symptom ...
, * to diagnose gynecologic
cancer Cancer is a group of diseases involving abnormal cell growth with the potential to invade or spread to other parts of the body. These contrast with benign tumors, which do not spread. Possible signs and symptoms include a lump, abnormal b ...
* in infertility treatments to track the response of
ovarian follicle An ovarian follicle is a roughly spheroid cellular aggregation set found in the ovaries. It secretes hormones that influence stages of the menstrual cycle. At the time of puberty, women have approximately 200,000 to 300,000 follicles, each with ...
s to
fertility medication Fertility medications, also known as fertility drugs, are medications which enhance reproductive fertility. For women, fertility medication is used to stimulate follicle development of the ovary. There are very few fertility medication options a ...
(i.e. Pergonal). However, it often underestimates the true ovarian volume. Through transvaginal sonography ovarian cysts can be aspirated. This technique is also used in
transvaginal oocyte retrieval Transvaginal oocyte retrieval (TVOR), also referred to as oocyte retrieval (OCR), is a technique used in in vitro fertilization (IVF) in order to remove oocytes from the ovary of a woman, enabling fertilization outside the body. Transvaginal oocy ...
to obtain human eggs (
oocyte An oocyte (, ), oöcyte, or ovocyte is a female gametocyte or germ cell involved in reproduction. In other words, it is an immature ovum, or egg cell. An oocyte is produced in a female fetus in the ovary during female gametogenesis. The female ...
s) through sonographic directed transvaginal puncture of ovarian follicles in IVF. Gynecologic ultrasonography is sometimes
overused South is one of the cardinal directions or compass points. The direction is the opposite of north and is perpendicular to both east and west. Etymology The word ''south'' comes from Old English ''sūþ'', from earlier Proto-Germanic ''*sun� ...
when it is used to screen for ovarian cancer in women who are not at risk for this cancer., which cites * * * * There is consensus that women with only average risk for ovarian cancer should not be screened with this procedure for cancer.


Sonohysterography

Sonohysterography is a specialized procedure by which fluid, usually sterile saline (then called saline infusion sonography or SIS), is instilled into the uterine cavity, and gynecologic sonography performed at the same time. A review in 2015 came to the conclusion that SIS is highly sensitive in the detection of intrauterine abnormalities in subfertile women, comparable to hysteroscopy. SIS is highly sensitive and specific test in the diagnosis of uterine polyps, submucous
uterine fibroid Uterine fibroids, also known as uterine leiomyomas or fibroids, are benign smooth muscle tumors of the uterus. Most women with fibroids have no symptoms while others may have painful or heavy periods. If large enough, they may push on the bl ...
s,
uterine anomalies A uterine malformation is a type of female genital malformation resulting from an abnormal development of the Müllerian duct(s) during embryogenesis. Symptoms range from amenorrhea, infertility, recurrent pregnancy loss, and pain, to normal func ...
and intrauterine adhesions (as part of Asherman's syndrome), and can be used as a screening tool for subfertile women prior to IVF treatment.


See also

*
Gynography Gynography (Spanish: ''ginógrafo''ginógrafo
wordmagicsoft.com
) is defined as "
Gynoroentgenology Gynoroentgenology is the abbreviation of gynecological roentgenology. It is the radiologic imaging of the gynecologic parts of the female human body in order to make a radiologic diagnosis of a gynecologic disease. The term gynecologic radiology i ...
*
Obstetric ultrasonography Obstetric ultrasonography, or prenatal ultrasound, is the use of medical ultrasonography in pregnancy, in which sound waves are used to create real-time visual images of the developing embryo or fetus in the uterus (womb). The procedure is a stan ...
* Sonosalpingography * Vaginal ultrasonography


References


External links


Information about Sonography
{{DEFAULTSORT:Gynecologic Ultrasonography Female genital procedures Fertility medicine Medical ultrasonography