Modern diagnostics is not complete without ultrasound. You can confirm or refute the diagnosis using this procedure. This method allows you to look inside the human body and see what was previously impossible.
The basis for
Most women go to the gynecologist due to the presence of complaints about their health condition. After the diagnosis, in the office during the reception, in addition to the tests, an ultrasound of the uterus or, as they say, pelvic organs is prescribed. This study is conducted to determine or establish the cause:
- failure in the menstrual cycle;
- pain in the abdomen, lower back, specific discharge and unpleasant odor from the genitals;
- bleeding in the middle of the cycle or after intercourse;
- inflammatory processes in the pelvic organs;
- infertility, problems with conception.
For example, an ultrasound of the uterus shows what needs to be done to stimulate the body to become pregnant. You can also track the degree of maturity of the follicles, on which the onset of ovulation depends, the readiness of the endometrium to accept a fertilized egg, the patency of the fallopian tubes.
Study preparation
Today, ultrasound of the uterus and appendages is usually done without preparation. This has been made possible thanks to a modern intravaginal sensor. Therefore, filling the bladder is no longer required. If the study takes place in a city clinic, then most likely, you will need to bring a condom for ultrasound (it is called, is sold in a pharmacy), a diaper and socks. A condom is necessary for hygienic use of the sensor, because externally it looks like a rod 12 cm long and 2-3 cm in diameter.
In a private clinic or medical center, usually all this is already included in the cost of the procedure. Therefore, a woman does not need to purchase anything in advance. In order to undergo a diagnosis, you just need to come to the reception.
During the study, the woman is lying on her back, her legs are bent at the knees. Slight discomfort may be felt, as the sensor is brought close to the cervix and it can touch it. The duration of the manipulations depends on whether the woman has deviations and complaints.
In rare cases, when the above method cannot be applied to a specific patient, it is possible to conduct a study with a transabdominal sensor (through the stomach). This method just requires preparation in order for the screen to display a clear picture. A woman is asked to fill the bladder, for example, drink 0.5-1 liter of pure water or tea half an hour or an hour before the start of the study. Diagnosis is also carried out in a prone position, you do not need to bend your legs, just keep calm and not move. Unpleasant sensations can occur when you press the sensor on the bladder.
There is also a transrectal sensor that can be used during the diagnosis of the state of the pelvic organs. This method is resorted to if the patient is a virgin, and a transabdominal probe is not effective. The preparation process is to eliminate products that form gases. Before the procedure, it is necessary to cleanse the intestines (for example, make a cleansing microclyster). The position to be taken during the diagnosis is on the side with legs bent at the knees. There may be discomfort during insertion of the sensor into the anus. To minimize pain, a diagnostic doctor uses a lubricant.
What day is better to go on a study
In order for the uterine ultrasound to be informative, the gynecologist usually advises on which days it is necessary to undergo a diagnosis. As a rule, to determine any changes, small formations (cysts, polyps), deviations from the norms in the pelvic organs, it is recommended to conduct an examination in the first half of the cycle, after the end of menstrual bleeding.
If the cause of the ultrasound examination is a suspicion of endometriosis, then the optimal time for the procedure is the second half of the menstrual cycle. If there is a suspicion of a tumor or fibroid, an ultrasound of the uterus is performed twice - at the beginning and at the end of the cycle. An emergency test is scheduled at any time.
What the results say
After the diagnosis, the specialist gives a conclusion. Ultrasound of the uterus (and, if necessary, its appendages) is deciphered by the attending physician. According to the specified data, he can determine whether there are deviations from the norm, for example:
- in the thickness of the endometrium;
- the size and shape of the body of the uterus, as well as its appendages;
- determine the presence of cysts, neoplasms, their location and structure.
Normally, according to ultrasound, the size of the uterus in women does not go beyond acceptable limits. Its contours are even, clear, the structure of the endometrium without any inclusions. Outwardly, the organ looks like a pear with an inclination forward. Some women are diagnosed with a backward uterine position. This does not mean that such a phenomenon is attributed to pathology. For a woman who does not plan a pregnancy, this position of the uterus does not threaten anything. Otherwise, there is a possibility that difficulties may arise with conception.
Before menopause, the uterus is normal, according to ultrasound, has the following parameters:
- thickness - 30-40 mm;
- width - 46-64 mm;
- length - 45-70 mm.
After the onset of menopause, the size and thickness of the uterus decreases to 42 mm (length), 30 mm (thickness), 44 mm (width).
When planning pregnancy, many women monitor the condition of the endometrium. They need to know that, depending on the day of the cycle, indicators change from smaller to larger. After an ultrasound, the uterus in conclusion reflects information about the M-echo. What it is? This is the density of the endometrium. The inner layer of the uterus depends on the day of the cycle. At its beginning, from the first to the fourth day, the endometrial index is from 3 to 9 mm, from the fifth to the fifteenth day - up to 15 mm, from the sixteenth day to the end of the cycle - up to 20 mm.
As for the adjacent space, closer to the middle of the cycle or after ovulation, fluid accumulation can be visualized there.
What is determined during diagnosis
When an uterine ultrasound is done, the state of its most dense layer is also assessed - myometrium. Normally, in its structure, it should be homogeneous. Rough contours may indicate a possible pathology. If at the same time the structure is heterogeneous, then adenomyosis is probably the case.
According to the position and size of the uterus, some diseases can be judged, for example, if:
- uneven contours - tumor, cancer, myoma;
- deviation of the organ from the norm - an adhesive or inflammatory process;
- neoplasms are visualized inside - polyps, cysts, fibroids;
- the endometrium is thicker than it should be during the study period - hyperplasia;
- the enlarged cervical canal or its structure is heterogeneous - an inflammatory process associated with a developing infection.
The pathology of the development of the uterus is hypoplasia, it can differ in the nature of the location (hypoplasia of the bottom, tubes, cervical, mixed, vaginal).
These indicators need to be compared with other studies that may be required to make an accurate diagnosis.
By the size of the uterus and appendages, it is possible to establish a disease such as polycystic ovary. At the same time, multiple cysts are visualized on the latter, the growth of fibrous tissue between them is noted. Polycystic is characterized by a decrease in organ size, while the ovaries, on the contrary, are enlarged. During a general diagnosis, a hormonal malfunction is established.
As for the various formations, it is worth noting the risk of developing polyps in the endometrium, which may not manifest themselves in any way. With ultrasound diagnosis, the doctor can detect an uneven growth of the inner layer of the uterus, as a result of which the diagnosis is endometrioid polyps.
Endometriosis
If during an ultrasound the doctor sees a seal in the endometrium, then this usually indicates the presence of endometriosis. At the same time, the inhomogeneous structure of the inner layer of the reproductive organ, with cysts present in some of its sections, is visualized on the screen. A deviation from the norms is recorded, the size of the uterus by ultrasound, as a rule, is slightly larger.
In order to exclude the development of a cancerous tumor, an analysis of the smear for cytology and a biopsy of the affected tissue is taken. When making a diagnosis, the results of an ultrasound study are also taken into account. If the existing changes can lead to the development of a tumor, then a second ultrasound examination is carried out after some time. It will determine how the tumor develops and its growth rate.
Uterine fibroids
This is a benign neoplasm, which for a long time may not manifest itself in any way. Diagnosed in 40% of women worldwide. Only under certain circumstances can it develop into a cancerous tumor. When carrying out ultrasound of the uterus, the degree of growth of fibroids is diagnosed in the weeks of pregnancy. This is explained by the fact that on the monitor the doctor sees a small round formation, like a fetal egg. Up to 5-10 mm in size it is diagnosed as a myomatous node. Usually its size increases at the end of the menstrual cycle. Therefore, ultrasound diagnostics is sent immediately after menstruation.
According to how the uterus looks on ultrasound, the following options for the location of fibroids are distinguished: submucous, intramural and subsuros.
It is noteworthy that the presence of neoplasms in the organ cavity does not interfere with the onset and normal course of pregnancy. However, its size is monitored separately. Pay attention to how far the node is from the place of attachment of the placenta. Since too close a location can disrupt the uteroplacental exchange, impair blood circulation between the mother and the fetus.
Too large fibroids can become an obstacle to the growth and movement of the fetus, affect its location in the uterus. As indications for childbirth, the need for a caesarean section can add.
When examining a woman after childbirth, they pay attention to the location of fibroids, as it was noted that during the restoration of the previous size of the uterus, she changed her location.
Ultrasound examination during pregnancy
Safe and quick diagnosis allows you to determine the norms of the uterus by ultrasound at any stage of pregnancy. When it is not yet greatly enlarged (at the beginning of pregnancy), the presence of tumors and cysts in the area of the appendages is determined. As the uterus begins to grow intensively closer to the second trimester, it becomes more difficult to visualize them.
Using ultrasound from the first weeks of pregnancy, you can monitor how the fetus develops, establish a heartbeat, determine the state of amniotic fluid, the height of the uterine fundus, and many other parameters. Prenatal diagnosis allows you to determine how the fetus is located inside (uterine or ectopic pregnancy, pelvic or head presentation). In order to identify genetic and congenital malformations, screening studies are conducted in the second and third trimesters.
The uterus during pregnancy increases in size, so the parameters of the placenta are measured separately. Assess its thickness, blood flow condition, degree of maturity. Usually, upon detection of any pathologies or multiple pregnancy, a photo is taken with an ultrasound of the uterus.
Neck diagnosis
The cervix deserves special attention, the rate of which should normally be at least 3 cm during pregnancy, and it should be closed. If its size in the process of bearing the baby becomes smaller, and the neck opens slightly, which can be detected by visual examination on the chair, then there is a risk of premature birth.
This item is given great attention throughout pregnancy, especially among those women who have experienced miscarriage and premature birth. If you deviate from the norms in conclusion, according to the results of an ultrasound study, the diagnosis of isthmic-cervical insufficiency is diagnosed.
Ectopic pregnancy by ultrasound
During an intravaginal examination of the vagina, an ectopic pregnancy can be diagnosed. When it is found by signs, but the fetal egg is not visualized in the uterine cavity, the diagnostician draws attention to the appendages, fallopian tubes. It is here that, as a rule, “gets stuck” and a fertilized egg develops.
In addition to condensation in the area of the fallopian tube, a small blood clot is also visualized on the screen behind it. Having established an ectopic pregnancy at an early stage, you can perform surgery and leave the tube intact. In the process of rehabilitation, a second ultrasound study is done, which helps to identify the degree of success of the performed manipulations.
Complications are caused by that ectopic pregnancy, which is visualized in the uterine cavity at an early stage (up to 6 weeks). But over time, it turns out that this is just a blood clot, which was mistaken for a fetal egg. In this case, you can miss the time for surgery, which leads to rupture of the fallopian tube. Therefore, the diagnosis of pregnancy in the early stages is carried out in several stages using additional methods, for example, a blood test for hCG.