What are gynecological ultrasound exams used for? How do they work? And why is it an important tool for women’s health?

Let’s start with an Ultrasound. What is it?

Maybe you remember in elementary school [or maybe it was middle school… ] when we learned about bats, dolphins, whales – and what they have in common? 

…I’m sure you’re thinking, what does this have to do with gynecological ultrasounds?

Well, yes, animals. And a super-power they possess called – echolocation. Echolocation is utilized to identify the objects they don’t see by sending out ultrasound waves. These ultrasound waves are reflected waves, like echos, that bounce off of prey or objects in the dark to help guide the animal in areas of sight that they cannot see. 

This technology used by animals is also used by humans. No… we do not call out in the dark hoping for an answer! Well… not in this instance.

And now that we’re all caught up on an old school science lesson:

We utilize ultrasound the same way. With the help of technology, ultrasound exams allow us to have a multitude of uses in the healthcare industry. Here, specifically with women. 

Viewing organs in the body can be difficult. *It’s dark in there* 

Ultrasound imaging is used to bounce sound waves off the structures and organs within the pelvis to produce pictures. Also known as ultrasound scanning or sonography.

This procedure is safe and renders no pain. Unlike x-rays, ultrasounds don’t use radiation and have no known risks to the patient. A small wand or transducer is used to probe or may be pressed against the skin. This produces tiny pulses of sound that are high-frequency and inaudible. These sound waves bounce off of internal organs, tissues, and fluid. The receiver in the transducer then records any tiny changes in frequency and direction that get instantly measured by a computer. This creates an image in real-time. 

Women use several types of ultrasound exams. Obstetric ultrasounds / pelvic ultrasounds (transvaginal / endovaginal) and transabdominal ultrasounds. OB ultrasounds used to determine the condition of a pregnant woman and her fetus. Endovaginal meaning within the vagina, extending from the uterus to the vulva. Transvaginal meaning across or through the vagina, extending from the uterus to the vulva. Both are types of pelvic ultrasounds. And transabdominal ultrasounds means through or over the abdomen.

For women, an ultrasound can be performed for various different reasons, conditions, and check-ups. 

It’s All About Obstetric Ultrasound Exams

Normally, clinically indicated: an obstetric ultrasound is used to observe the condition of a pregnant woman. A doctor may order an ultrasound for many different reasons:

• To determine if a woman is pregnant
• If she is pregnant, how far along she is pregnant
• To see if there are genetic disorders
• To evaluate the location of the fetus and placenta
• The size and weight of the fetus
• The movement breathing and heart rate
• Check for ectopic pregnancy
• And to check if there is more than one pregnancies

With pregnant women, there is an option to have a limited ultrasound exam. This is used to check the positioning of the fetus or if there is a condition like vaginal bleeding, an ultrasound can help find out if the placenta is too low. As well as help find up to date conditions like the heartbeat of the fetus. 

Another option is a specialized ultrasound exam. These exams are based on risk factors. If there is a possible issue with the fetus not going well. This exam can be used when there are signs of distress. The fetus can be tracked multiple different ways. 

This can be through a doppler ultrasonography and 3-D ultrasonography.

Pelvic Ultrasound Imaging – Transvaginal Exams

This is the best procedure for doctors to take a look at the female pelvic organs and is extremely common for women who are pregnant. 

Pelvic ultrasounds are also used to evaluate the lower abdomen, organs and tissue in the:

• Cervix
• Fallopian tubes
• Bladder
• Uterus
• Ovaries
• Endometrium

Usually performed to view the endometrium and myometrium. In other words, the lining of the uterus, and the muscular walls of the uterus. Allows for a more in-depth evaluation in an area of the body that can be difficult. And otherwise, could not be imaged directly. 

These ultrasounds allow for doctors to detect uterine: scars, endometrial polyps, fibroids, anomalies, and cancer. 

Transvanginal ultrasounds simply mean ‘through the vagina’. This type of ultrasound may be routine throughout pregnancy or help diagnose certain conditions a woman might be experiencing. It’s there to help to find cancer of the reproductive organs, pelvic infections, miscarriages, placenta previa, cysts, etc. 

These are transvaginal ultrasounds are necessary to:

• Look for possible pelvic pain 
• Locate an IUD device
• Abnormal / Unexplained bleeding or menstrual issues
• Evaluate a mass in the uterus such as a fibroid, ovarian cyst, or tumor
• Diagnose infertility and administer treatment (used with 3-D ultrasound)
• Look for an ectopic pregnancy

A transvaginal ultrasound and what a doctor may be looking for will depend on your symptoms. 

Transabdominal Ultrasounds

Opposite transvaginal ultrasound exams, transabdominal ultrasound exams are conducted over the abdomen. 

During these ultrasound exams, your doctor will have you reclined on a table. Abdomen exposed. Your healthcare provider will then apply a gel to your abdomen that will remove excess air between your skin and the transducer. As well as improve the conduction of sound waves.

Scanning the transducer back and forth over your abdomen, your body will reflect sound waves off bone and tissue which get converted into a still or moving image on a monitor. 

A healthcare provider normally recommends fetal ultrasounds to:

• Determine gestational age which helps track milestones and provide an accurate due date for birth.
• Confirm how many babies if there is suspicion for multiple pregnancies
• To determine if growth is happening at a normal rate and to monitor a baby’s movement and heart rate.
• To ensure the placenta and amniotic fluid levels are where they’re supposed to be. A fluctuation of these vital nutrients can mean the pregnancy needs special attention. An evaluation of the placenta and amniotic fluid around the baby can allow your doctor to reassure you that your baby is being provided with vital nutrients and oxygen rich blood. 
• Try to screen for birth defects
• To provide other prenatal tests
• To determine proper delivery. Babies normally are positioned head first but that’s not always the case. This can confirm the position of the baby and discuss options for delivery. 

In the first trimester, an ultrasound exam is done to screen for abnormalities of your uterus and cervix. And when pregnant, it is used to determine the size, the age, and number of fetuses, if there’s a chance for multiple pregnancies. 

In the second and/or third trimester a transabdominal ultrasound is performed to evaluate the growth of the fetus, the anatomy and the features of the pregnancy. 

Otherwise normally, depending on your baby’s position and stage of development, the ultrasound will be able to take pictures of the baby’s face, arms and legs, and fingers. 

During these trimesters, an additional evaluation may be needed if there are any anomalies or birth defects during the pregnancy. This could be unusual fetal growth and volume of amniotic fluid. Also because of previous pregnancy history.

There are a couple of transabdominal ultrasounds that your healthcare provider might recommend:

• Doppler Ultrasound – this measures changes in objects such as blood cells and blood flow.
• Specialized Sonogram – this can provide details about anything abnormal with the pregnancy or possible circumstances around the baby
• Fetal Echocardiography – specifically provided to picture the baby’s heart and used to rule out any defects
• 3D Ultrasound – used to help healthcare providers with detecting physical abnormalities or tube defects

The Benefits of Having Ultrasound Exams

Ultrasounds have a lot of benefits. It’s considered a noninvasive and not-painful approach to examining your body and baby’s health. It’s widely and commonly available and inexpensive in comparison to other imaging methods. It doesn’t use radiation and is considered a very safe method. Opposite of x-rays. It also can develop clear images of soft tissue. Images which are provided in real-time and makes for a very efficient and effective way to monitor ‘mama and baby.’ 

These exams are all for health assurance. As well as the knowledge to know your baby is growing to be healthy and developing normally. It gives your healthcare provider insight and early attempts to preemptively avoid any anomalies that may come with pregnancy. Or address them altogether. Talk to your doctor if you think you might be pregnant, feel abnormalities within your pregnancy, or maybe are just looking for reassurance during your first or third trimesters…

Come Visit Your Manhattan OBGYN

The team at Rosh Maternal & Fetal Medicine offer regular 2D, as well as advanced 3D and 4D ultrasounds, which produce three-dimensional and live streaming images of the baby’s movement. If you’re interested in getting an ultrasound, please call their office in the Midtown East area of New York City, or schedule a consultation online.

Talk to our team by phone or book an appointment online to get started. Call one of our six convenient NYC locations or schedule a video consultation online today. Come visit your NYC OBGYN.