Pelvic Ultrasound in Women: What the Examination Shows

Pelvic ultrasound is an examination in which ultrasound waves are used to produce images of the uterus, ovaries, fallopian tubes, cervix, and pelvic tissues. There is no X-ray radiation here, so the method is also used during pregnancy. Let us break down exactly what is examined, how the types of examination differ, and how to read the report.

What pelvic ultrasound is and which organs are assessed

Sonography is non-invasive: the probe sends waves, and the machine builds an image from the reflected signal. For pelvic organs, frequencies of 2.5–3.5 MHz are used, and the resolution of modern machines reaches fractions of a millimeter. Almost the entire signal is reflected at the skin-air boundary, so gel is applied to the skin — it acts as a transition medium.

The uterus and its cervix, the ovaries, the fallopian tubes, and the pelvic region as a whole are assessed. The decision on further examinations is made by the doctor.

Types of gynecological ultrasound: transabdominal and transvaginal

In the external, transabdominal, variant, the probe is moved over the skin of the abdomen. In the internal, transvaginal, variant, a thin tubular probe is inserted into the vagina. The probe is covered with a condom and lubricant.

There is usually no pain; there may be mild discomfort from pressure. You control the process: you can ask for a pause, stop the examination, or invite a companion. To see the uterus more clearly, saline infusion sonography is sometimes used.

What uterine ultrasound shows: fibroids, growths, enlargement

The images show cysts, fibroids (fibromas), and other growths, as well as enlargement of the uterus. Such findings are considered possible deviations from the norm.

What ovarian and adnexal ultrasound shows

Ultrasound can show cysts and benign growths, inflammation, endometriosis, and ovarian torsion. Ectopic pregnancy is one of the conditions for which the examination is prescribed.

For some types of infertility, ovarian ultrasound is included in the list of examinations.

How to read the report

A normal result means that the pelvic structures, and during pregnancy the fetus, are normal. An abnormal result is possible in many conditions: congenital features, benign formations such as cysts and fibroids, inflammation, including pelvic inflammatory disease, endometriosis, ectopic pregnancy, ovarian torsion, uterine enlargement, as well as malignant processes of the uterus, ovaries, vagina, and other pelvic structures.

The protocol is sent to the doctor who referred you for the examination. You can discuss the result and further steps with them.

When a doctor prescribes pelvic ultrasound and how to prepare for it

A referral is given for lower abdominal pain, abnormal bleeding and menstrual irregularities, for changes found on examination, for some types of infertility, for suspected ectopic pregnancy, and during pregnancy.

Preparation depends on the type of examination. The clinic may ask you to come with a full bladder; for transvaginal it is empty or partially filled. Usually you are asked to:

• check with the clinic whether a full bladder is needed;
• remove jewelry and piercings in the scanning area;
• undress below the waist and cover yourself with a sheet;
• report latex allergy;
• invite a companion if you wish.

The procedure lasts approximately 10–45 minutes, sometimes longer. The result may be given immediately or after a few weeks; the protocol is sent to your doctor.

Pelvic ultrasound by itself is not a reason to call an ambulance; 103/112 — for a life-threatening condition, for example sudden sharp deterioration in well-being.

Discuss the results with a gynecologist. This material is for reference: it explains what pelvic ultrasound shows but does not replace a doctor's consultation.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer