A transvaginal ultrasound is a specialized type of imaging used to look at the female reproductive system.

Different from an abdominal ultrasound, which is done from the outside, this procedure involves inserting a probe into the vagina. It is used for a range of reasons, from monitoring pregnancy to checking for abnormalities in organs such as the uterus, ovaries, and cervix.

If your doctor has recommended a transvaginal ultrasound, you may have questions. This article will explain how it works, when it is used, how to prepare, and what you can expect.

What is a Transvaginal Ultrasound?

A transvaginal ultrasound uses high-frequency sound waves to create detailed images of the internal organs, specifically in the pelvic region. The procedure is an important tool for diagnosing a variety of conditions that affect the uterus, ovaries, fallopian tubes, cervix, and vagina.

It provides a more detailed view of the pelvic organs than abdominal ultrasounds due to its internal nature.

During the exam, a small ultrasound probe is inserted into the vagina. The probe sends out sound waves. They bounce off the organs and create a detailed image. This method allows doctors to examine areas that are difficult to see with an external ultrasound.

When is a Transvaginal Ultrasound Performed?

There are several reasons a doctor might recommend a transvaginal ultrasound. Some of the most common include:

• Unexplained Pelvic Pain: Doctors may use it to investigate sources of pelvic discomfort.
• Abnormal Vaginal Bleeding: This may indicate conditions such as fibroids or cysts.
• Infertility: To identify problems with reproductive organs.
• Pregnancy Complications: To monitor fetal development, check the placenta, or rule out ectopic pregnancy.
• Cyst or Uterine Fibroid Checks: To confirm or rule out the presence of fibroids or cysts.
• IUD Placement: To verify the proper placement of an intrauterine device.

It is also often used to monitor a pregnancy in its early stages–particularly in cases where a woman is at risk for miscarriage or other complications.

Transvaginal ultrasounds offer more precise imaging in early pregnancy than external methods. This allows for accurate fetal monitoring.

Preparing for a Transvaginal Ultrasound

Preparation for a transvaginal ultrasound is generally minimal. However, there are some important steps to follow:

• Clothing: You will need to undress from the waist down and put on a gown.
• Bladder Considerations: Depending on the reason for the ultrasound, your doctor may ask you to have an empty or partially full bladder. A full bladder can help push your organs into a better position for clearer imaging.
• Menstrual Cycle: If you are on your period or spotting, you may be asked to remove any tampons before the ultrasound.

Your doctor will share specific instructions based on your situation. That’s why it is important to follow them carefully.

The Transvaginal Ultrasound Procedure

Once you are prepared, the procedure typically lasts about 30 minutes to an hour. Below’s what you can expect:

• Positioning: You will lie down on an examination table with your knees bent. In some cases, stirrups may be used to help hold your legs in place.
• Insertion of the Probe: Your doctor or ultrasound technician will cover the transvaginal ultrasound probe with a condom-like cover and apply a lubricating gel. The probe will then be inserted about 2 to 3 inches into your vagina. This may cause some pressure. However, it should not be painful. If you feel any discomfort, it is important to tell your healthcare provider.
• Imaging: As the probe moves within the vaginal canal, sound waves bounce off your pelvic organs and transmit images to a monitor. Your doctor or technician will rotate the probe to capture images from different angles.
• Saline Infusion Sonography (SIS): In some cases, a special version of the transvaginal ultrasound called saline infusion sonography may be used. In this procedure, a small amount of sterile salt water is injected into the uterus before the ultrasound to get a clearer view of the uterus and its lining. This can help detect uterine abnormalities that might not be visible with a standard ultrasound.

Risks and Discomforts Associated with Transvaginal Ultrasound

A transvaginal ultrasound is considered a safe procedure. There are no known long-term risks. It can be performed during pregnancy, as it does not involve radiation.

However, the process may cause some mild discomfort, especially during the insertion of the probe. You may feel pressure or a slight sense of fullness. However, the procedure is generally not painful.

If you experience significant discomfort, make sure to inform your doctor or technician right away.

Additionally, there are no major risks associated with saline infusion sonography (SIS). Nevertheless, it may cause mild cramping or spotting afterward. If you are uncomfortable during the procedure, the technician will pause and adjust the positioning.

What Does a Transvaginal Ultrasound Detect?

A transvaginal ultrasound can identify several health issues, including:

• Pregnancy Monitoring: It can confirm early pregnancy and monitor fetal development, including checking for abnormalities.
• Pelvic Cysts or Fibroids: Transvaginal ultrasounds are often used to identify or monitor the size of cysts and fibroids in the reproductive organs.
• Ectopic Pregnancy: The ultrasound can help determine if a pregnancy is growing outside the uterus, which can be a life-threatening condition.
• Cervical or Uterine Problems: Conditions such as uterine cancer, cervical abnormalities, or infections can be detected using transvaginal ultrasound.
• Miscarriage or Bleeding: In cases of abnormal bleeding or suspected miscarriage, a transvaginal ultrasound helps identify the cause and guide treatment.
• Placenta Previa: This occurs when the placenta is too low in the uterus and could block the birth canal. This can lead to complications during childbirth.

After the Procedure

After the transvaginal ultrasound, you can resume normal activities. You may feel some minor discomfort or spotting, but these symptoms typically go away within a day.

Your doctor will analyze the images and share the results with you. If there are any concerns, further tests or treatments may be suggested. For example, if fibroids or cysts are detected, your doctor will discuss possible treatment options–depending on their size and symptoms.

In cases where abnormalities are detected, your doctor will work with you to develop a care plan and possibly order additional tests or procedures to confirm a diagnosis.

What Happens If the Results are Abnormal?

It is important to remember that an abnormal result does not necessarily mean you have a serious health issue.

Many times, conditions such as fibroids or cysts are benign and do not require immediate intervention. In some cases, a follow-up ultrasound or additional imaging may be required to monitor changes over time.

If your doctor detects something concerning, they may suggest further diagnostic tests or treatments. For example, if you have abnormal bleeding, your doctor might recommend additional tests to rule out conditions like cancer or infections.

If further tests are needed, your doctor will explain why they are recommended and what they aim to uncover. Treatment options will be discussed based on the diagnosis. If you require medication, surgery, or monitoring, your doctor will make sure that you are fully informed and comfortable with the next steps.

Rosh Maternal & Fetal Medicine knows that any medical procedure can be nerve-wracking. Our team of compassionate professionals is here to protect your experience with transvaginal ultrasound as comfortable as possible.

We offer expert guidance every step of the way. If you have any questions about the procedure or need to schedule an ultrasound or pregnancy care services, we are here to help.

Reach out to us today to learn more about our pregnancy ultrasound services and the wide range of other services we deliver.