Ultrasound

Ultrasound was introduced into clinical medicine in the late 1950's. We currently use e Quipment called real-time scanners, which provide a continuous moving picture. A transducer emits very high frequency sound waves, which are reflected back from surfaces (Figure 4.1). The reflected beam is detected and can be seen on a monitor screen. Ultrasound is safe, cost effective, non-invasive and an accurate technique for evaluating the internal reproductive organs in gynaecology and the fetus during pregnancy. Many gynaecological and early pregnancy ultrasound examinations are undertaken with a small vaginal transducer, which can be placed close to the uterus and ovaries: this is known as a transvaginal or internal scan.

Ultrasound examination can demonstrate structural abnormalities such as fibroids and ovarian cysts. For patients with infertility problems, ultrasound provides information on oocyte (egg) development and in IVF the eggs are collected under direct ultrasound visualisation (Q10.24). Ultrasound may provide reassurance about the endometrium in patients with postmenopausal bleeding reducing the requirement for invasive investigation of the uterus (Q 26.17). Breast ultrasound examination has a role to play in screening women under the age of 40 and also supplements mammography (Q32.35).

In pregnancy, ultrasound provides:

 essential information on the dating of the pregnancy.

 assessment of bleeding in early pregnancy.

 detection of ectopic pregnancy.

 early detection of multiple pregnancy.

 assistance in the diagnosis of some congenital foetal abnormalities including:

Down syndrome.

The spina bifida group.

Heart.

Skeleton.

an indication of the site of the placenta and the growth rate of the fetus in later pregnancy.

Forty years of experience with ultrasound in pregnancy has shown that it is remarkably safe.

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