Gynaecology Protocols

Ultrasound scanning guidelines

Gynaecology Method of investigation: Transabdominal, transvaginal or both may be used to investigate the female pelvis. Transvaginal scanning gives better detail of uterus, ovaries & adnexa. Clinical information, instruction from the referring doctor and/or discussion with the radiologist /sonologist may determine which method(s) will be utilized. The sonographer may proceed to transvaginal scanning (either as initial investigation or following transabdominal scanning) without discussing the case with the radiologist Sonographers should discuss a case prior to performing transvaginal scanning if they have any concerns, whether of a technical, social or clinical nature Consent: Informed consent must be obtained from the patient prior to performing a transvaginal scan. If the patient requiring transvaginal scanning is a minor (under 16 years of age), the sonographer must obtain the consent of the patient’s parent or guardian. In this case both the patient and parent should sign the consent form Assess: Uterine echotexture Endometrial thickness Uterine size / shape / position Uterine contour / endometrium / myometrium Ovarian echotexture Ovarian size / shape Ovarian follicles / cysts Pouch of Douglas Adnexal regions Cervix Kidneys if mass seen in pelvis, document degree of obstruction at upper calyx infundibulum Standard documentation - transabdominal: Longitudinal views of uterus Rt / midline / Lt Transverse views of uterus inf / mid / fundus Cervix Ovarian measurement long / transverse Zoomed view of endometrium with measurement of thickness (nb: Transvaginal method more accurate measurement) Standard documentation - transvaginal: Longitudinal views of uterus Rt / midline / Lt Longitudinal view of the cervix / pouch of Douglas Coronal cervix Coronal uterus inf / mid / fundus Ovarian measurement longitudinal and coronal Zoom view of endometrium with measurement of thickness

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