While performing the scan, you may use the vaginal probe as though it were your examining fingers, putting pressure on different structures to see if they are tender or fixed in place. Similarly, you may use your other had abdominally to press down, bringing structures closer to the vaginal probe. This type of dynamic ultrasound scanning may provide information you might otherwise miss.
The Normal Uterus
Measure the uterus in three dimensions, total length, width and depth.
Sweep through the uterus both lengthwise and transversely, evaluating the myometrium for the presence of fibroids. Small cystic masses in the cervix are Nabothian cysts and are of no clinical significance.
Fibroid tumors are the most common uterine abnormality seen with ultrasound. These round masses are seen within the myometrium or projecting out from the myometrium.
Normal ovaries appear lateral to the uterus and vary in their relative position within the pelvis. In this example, the ovary lies in the classical position just above the vessels. In other cases, the ovaries may be quite remote from this location.
During childbearing years, the ovaries are usually readily identified by the presence of small ovarian follicles. As the menstrual cycle advances, several ovarian follicles are recruited and grow to 8-12 mm in diameter. Then, one dominant follicle is usually selected which continues to grow at 2-4 mm/day, until it reaches about 25 mm (22-30). It then releases the egg and partially collapses, forming a corpus luteum.
If there is any internal bleeding into the cyst cavity, the corpus luteum takes on an irregular, "cob-web" appearance that promptly resolves. This is known as a hemorrhage corpus luteum cyst and is innocent, though it has a somewhat disturbing ultrasound appearance.
At menopause, the ovarian follicles no longer grow and the ovary may become difficult to identify.
Similar findings can be seen among long-term oral contraceptive pill users, although the changes are generally not as dramatic.
A large number of ovarian abnormalities can be seen, among them cysts, solid tumors, and endometriomas.
OB-GYN 101: Introductory
Obstetrics & Gynecology
Contents · Introduction · Learning Objectives · Clinical Issues · Procedures · Library · Pharmacy · Lab · Chest X-ray · Ultrasound · Videos · Forms · Progress Notes · Facts Cards · Students · Search · Feedback · About Us