Gynecological Ultrasound

Gynecological ultrasound is an essential part of modern gynecology, used to diagnose and monitor diseases and conditions of the female reproductive system. Various ultrasound techniques are employed based on diagnostic needs, such as color Doppler, 3D/4D ultrasound, and sonohysterography. Since it does not use harmful ionizing radiation, ultrasound is an indispensable and completely safe diagnostic method in gynecology.

What is gynecological ultrasound?

Gynecological ultrasound is a non-invasive, safe, and effective diagnostic test that uses high-frequency sound waves to visualize the female reproductive organs and pelvic structures. Therefore, it is necessary to supplement the palpatory gynecological examination, during which a specialist gynecologist uses their hands to palpate the internal organs vaginally or rectally, assessing their relationships and any possible tenderness.

Gynecological ultrasound provides information about:

The size, position, and shape of the uterus and ovaries
The presence of free fluid in the pelvis
The length and thickness of the cervix
Blood flow through pelvic organs (using color Doppler)

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How is gynecological ultrasound performed?

Gynecological ultrasound can be performed in three ways: transvaginally, transabdominally, and, if necessary, transrectally.

Transvaginal ultrasound: This is the most common method for women who have had vaginal intercourse. It is performed with the patient in a semi-reclining position with legs supported in stirrups. A condom and lubricant are applied to the ultrasound probe to facilitate its insertion into the vagina.

Transabdominal ultrasound: This is conducted over the abdominal wall by applying ultrasound gel to the probe and the abdomen to ensure smooth movement and better sound conduction. This examination is performed in women who have not had their first sexual intercourse or as a supplement to a transvaginal ultrasound to provide a comprehensive view of the pelvic structures.

Transrectal ultrasound: This serves as an alternative to transabdominal ultrasound for women who have not had vaginal intercourse. It is performed similarly to transvaginal ultrasound but involves inserting the probe through the rectum.

Ultrasound imaging techniques

Depending on what needs to be visualized and with what precision, several imaging techniques are used beyond basic 2D ultrasound:

3D ultrasound:

This provides a three-dimensional image and is useful for:

Diagnosing congenital anomalies of the uterus (e.g., septate uterus, bicornuate uterus)
Identifying benign uterine growths (e.g., polyps, fibroids, intrauterine adhesions)
Assessing the appearance and nature of ovarian cysts and tumors
Evaluating the placement of an intrauterine device (IUD)

In prenatal diagnostics, it:

Offers a clearer and sharper image of the fetus and its facial features
Allows more precise diagnosis of pathological conditions, including various types of fetal malformations (e.g., cleft lip and palate, spina bifida, tumors)

4D ultrasound:

This provides real-time 3D imaging, allowing observation of fetal movements such as smiling, thumb sucking, yawning, and frowning during pregnancy.

Color Doppler:

Color Doppler is a special ultrasound method that visualizes blood flow in blood vessels. In gynecology, it helps differentiate between benign and malignant growths by analyzing blood flow patterns, as malignant tumors are usually more vascularized.

In obstetrics, color Doppler is used for:

Monitoring normal fetal development
Diagnosing heart abnormalities
Tracking blood flow
Identifying complications related to the mother or fetus

Sonohysterography:

This ultrasound technique examines the uterine cavity, cervical canal, and fallopian tube patency.

It involves injecting a saline solution into the uterus through a thin catheter while using 2D or 3D ultrasound to monitor the flow of the fluid through the fallopian tubes. If the tubes are blocked, the fluid cannot reach the abdominal cavity.

Sonohysterography is useful for visualizing intrauterine abnormalities that may not be visible with standard 2D ultrasound. The best time for this test is immediately after the end of menstrual bleeding.

Indications:

Intrauterine adhesions
Polyps
Submucosal fibroids
Lost intrauterine device
Infertility diagnostics

Contraindications:

Pregnancy
Pelvic inflammatory disease
Bleeding

When is gynecological ultrasound needed?

Gynecological ultrasound should be part of routine gynecological check-ups once a year. However, the frequency may vary based on symptoms, monitoring of existing conditions, or post-surgical follow-ups. Gynecological ultrasound is performed during the initial gynecological examination and is indicated for:

Pelvic pain
Monitoring ovarian cysts
Monitoring uterine fibroids and polyps
Menstrual irregularities (painful, heavy, irregular, or absent periods)
Diagnosis and confirmation of pregnancy
Post-surgical and postpartum follow-ups
Infertility treatment
Postmenopausal bleeding

Gynecological ultrasound is best performed in the first phase of the menstrual cycle, right after menstruation (days 5-15 of the cycle). For diagnosing uterine anomalies, it is performed around day 21 of the cycle.

Gynecological ultrasound during pregnancy

Gynecological ultrasound is the most reliable method for confirming pregnancy after a home pregnancy test and a blood test for beta HCG. In high-risk pregnancies or if symptoms like pain or bleeding occur, ultrasound should be performed as soon as pregnancy is confirmed.

The number of ultrasounds during pregnancy depends on the patient’s medical history, whether the pregnancy is high-risk or normal, and other factors affecting the course of the pregnancy. Typically, three ultrasounds are done during a healthy pregnancy, one in each trimester.

Preparation for gynecological ultrasound

No special preparation is required, except for managing bladder fullness or emptiness. For transvaginal or transrectal ultrasound, the bladder should be emptied beforehand, while for transabdominal ultrasound, it should be filled with 1.5-2 liters of fluid. For your own comfort, you may wear loose-fitting clothing that is easy to remove during the examination.

Price of gynecological ultrasound

You can check the current price list for the cost of the procedure. Contact us by phone at +385 1 5005 970 or email info@sinteza.hr for more information.

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