Pelvic Ultrasound

Pelvic ultrasound is a procedure where harmless, high-frequency sound waves are projected into the abdomen. These waves reflect off of the internal structures and create shadowy black and white pictures on a display screen.

Purpose

Ultrasound is performed routinely during pregnancy. Early in the pregnancy (at about seven weeks), it might be used to determine the size of the uterus or the fetus, to detect multiple or ectopic pregnancy, to confirm that the fetus is alive (or viable), or to confirm the due date. Toward the middle of the pregnancy (at about 16–20 weeks), ultrasound may be used to confirm fetal growth, to reveal defects in the anatomy of the fetus, and to check the placenta. Toward the end of pregnancy, it may be used to evaluate fetal size, position, growth, or to check the placenta. Doctors may use ultrasound during diagnostic procedures like amniocentesis and chorionic villus sampling. Both of these tests use long needles inserted through the mother's abdomen into the uterus or placenta to gather cells. Ultrasound can also be used in men or women to examine other internal organs, such as the liver, gallbladder, kidney, and heart. The procedure can be useful in detecting cysts, tumors, and cancer of the uterus, ovaries, and breasts.

Precautions

There are no special precautions recommended before an ultrasound examination. Unlike x rays, ultra-sound does not produce any harmful radiation and does not pose a risk to the mother or the fetus. While many woman have an ultrasound as part of their prenatal care, there may be no medical need to perform the procedure.

Description

Ultrasound examinations can be done in a doctor's office, clinic, or hospital setting. Typically, the pregnant

An ultrasound image of Anabelle Ashlyn Longe at 20 weeks. (Courtesy of Jacqueline Longe.)

woman will lie on an examination table with her abdomen exposed. Gel or oil is applied to the area. The doctor or technician will move a hand-held scanner (called a transducer) over the abdomen. The transducer emits high-frequency sound waves (usually in the range of 3.5–7.0 megahertz) into the abdomen. The waves are reflected back to the transducer and the wave patterns are shown as an image on a display screen. An ultrasound scan reveals the shapes, densities, and even movements of organs and tissues. Although the pictures transmitted by an ultra-sound scan appear gray and grainy, a trained technician can identify the fetus within the uterus, monitor its heartbeat, and sometimes determine its sex. Using computerized tools, the technician can measure various structures shown on the screen. For example, the length of the upper thigh bone (femur) or the distance between the two sides of the skull can indicate the age of the fetus.

Ultrasound technology has been used safely in medical settings for over 30 years, and several significant improvements have been made to the procedure. A specially designed transducer probe can be placed in the vagina to provide better ultrasound images. This trans-vaginal or endovaginal scan is particularly useful in early pregnancy or in cases where ectopic pregnancy is suspected. Doppler ultrasound uses enhanced sound waves to monitor subtle events, like the flow of fetal blood through the heart and arteries. Color imaging is a recent addition to ultrasound technology. With this process, color can be assigned to the various shades of gray for better visualization of subtle tissue details. A new technology under development is three-dimensional ultra-sound, which has the potential for detecting even very subtle fetal defects.

Preparation

Before undergoing a pelvic ultrasound, a woman may be asked to drink several glasses of water and to avoid urinating for about one hour before the examination. When the bladder is full, the uterus and fetus are easier to see. A lubricating gel or mineral oil may be applied to the area to make moving the transducer easier.

Aftercare

The lubricating jelly or oil applied to the abdomen is wiped off at the end of the procedure. After an ultrasound examination, a patient can immediately resume normal activities.

Risks

There are no known risks, to either the mother or the fetus, associated with the use of ultrasound.

Normal results

The reliability of ultrasound readings depends on the skill of the technician or doctor performing the scan. Patients should be aware that fetal abnormalities cannot be detected with 100% accuracy using ultrasound. A normal ultrasound result does not necessarily guarantee that the fetus will be normal.

Abnormal results

Ultrasound examinations in obstetrics may detect abnormalities or defects in the fetus. This information may reveal that the fetus cannot survive on its own after birth or that it will require extensive treatment or care. Some surgical procedures can be performed to correct defects while the fetus is still in the uterus. Parents faced with information regarding possible birth defects may require counseling to consider their choice to either continue or end the pregnancy.

The diagnostic use of ultrasound may reveal the presence of cysts, tumors, or cancer in internal organs.