PELVIC ULTRASOUND
This is not an operation. It is a procedure so commonly used in obstetric and gynaecological investigation that it probably deserves a special mention. It is used as an imaging technique for several procedures, like egg pick-up operations in IVF, and for amniocentesis in early pregnancy. The fact that this technique does not use x-rays means it is of particular use in pregnancy, when radiation is best avoided.
Aims. To display internal structures using sound waves.
Indications. Investigating, examining and measuring internal structures in the pelvis, for example looking for ovarian cysts and tumours, abnormalities of the uterus, ectopic pregnancy, measuring the gestation (age) of an early pregnancy, assessing the anatomy and well-being of a foetus, localising the placenta, imaging structures for investigations and procedures such as foetal blood sampling, etc., and many more.
Method. A probe, a bit like a microphone, is attached, via a cord, to a machine with a screen, a bit like a television screen. The probe sends pulses of tiny sound waves (that you can’t hear). These pass through different layers of the body at different rates. The machine somehow manages to interpret the ‘echoes’ it receives from the various layers the sound waves hit. This way, a picture can be built up of the layers, and an image is formed.
To get a good picture of what is in the pelvis, a ‘window’ of water helps. We are fortunate that our bladders sit in front of our pelvic organs, as a full bladder serves this function very well. This is why women having a pelvic ultrasound will be asked to come along with a full bladder, and not to empty it until the scan is done.
The probe is moved around on the skin of the lower abdomen, and a special gel is used to make contact between the probe and the skin, to get a better picture. If the picture is not as clear as it needs to be, sometimes a special probe is used. This probe is inserted into the vagina. The images are generally clearer, because the waves do not have to pass through so much extra tissue. Scans ordered by a gynaecologist will often be performed in this way.
The pictures and measurements obtained in the scanning procedure then need to be interpreted by an expert ultrasonologist.
Complications. Apart from the discomfort of having a full bladder for a while, this is really a pretty safe procedure. There is no radiation, as there is in x-rays, and there are no known long-term side-effects from ultrasound.
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