This document discusses the history and uses of ultrasound in gynecology. It was first introduced in 1950 by Ian Donald from Glasgow, UK. Ultrasound is commonly used due to its safety, acceptance, and low cost. Higher frequencies provide better resolution but lower tissue penetration. Ultrasound is used for infertility issues, diagnosing ovulation and ectopic pregnancy, IVF procedures, and evaluating ovarian and uterine masses, cancers, and other gynecological diseases and abnormalities. Transabdominal and transvaginal ultrasound are the main types used. The document provides details on performing transvaginal ultrasounds and evaluating various reproductive organs and structures.

1. Dr.Suresh Babu Chaduvula
Professor
College of Medicine, KKU,
Abha, Saudi Arabia

2.  Ultrasound was 1st introduced by Ian Donald
in 1950 from Glasgow, UK.
 Father of ultrasonography – Ian Donald
 Ultrasonography is commonly used
diagnostic test due to high safety, more
acceptance and low cost.

3.  3.5 MHz frequency is used in abdominal
ultrasound where as 5-7.5 MHz is used in
vaginal type.
 Higher is the frequency more will be the
resolution of the image but lower will be the
depth of tissue penetration.

4.  1. Infertility – for folliculometry and
endometrial thickness.
 2. Diagnose ovulation time of ovulation
 3. Ectopic pregnancy
 4. Oocyte retrieval in IVF
 5. Ovarian masses like cysts and tumors
 6. Uterine fibroid, Tubo-ovarian masses

5.  7. Oncology- Color Doppler – low impedance
and high flow velocity suspects of
malignancy.
 8. Endometrial diseases – polyps, fibroid,
growths
 9. Misplaced IUCD
 10. DUB or AUB and post menopausal
bleeding
 11. Pelvic pain causes
 12. Molar pregnancy
 13. Malformations of uterus and vagina

6.  1. Trans abdominal
 2. Trans vaginal

7.  Bladder should be full [ Full bladder will push
bowel away from the field- acoustic window]
Explain
 Consent [verbal]
 Female attendant [chaperone]
 Privacy
 Gentle
 Brief Gynecological history
 Examination findings – abdominal and vaginal

8.  Bladder full is not needed
 It has a range of about 8-10 cm.
 Wear a pair of Gloves
Trans-vaginal probe movements:
a] Penetrating – introducing into vagina
b] Rocking – antero-posterior movement
c] Sliding – lateral movement
d] Roatating – to 45 to 90 degrees
 Drawbacks –
 1. Virgins
 2. Elderly Postmenopausal women
 3. Post radiation stenosis
 4. Children
 5.Psycho-sexual disorder

9.  Identify bladder
 Uterus size – 6-8X5X4 cm
 Uterus position – anteverted or retroverted
 Myometrium
 Cervix – for growths like polyps or fibroids
 Endometrial lining
 Bilateral ovaries
 Any other adnexal masses – ovarian or fallopian
tubal masses
 Color Doppler – flow of the blood in a vessel can
be identified
 Fluid in the Pouch of Douglas

11.  Proliferative phase – 2-4 mm
 Secretory phase – 5 - 14 mm
 In post-menopausal women – more than 4
mm warrants or is an indication for biopsy

25. Thank You All