ultrasound in gynecology - dr.suresh babu chaduvula
DESCRIPTION
This presentation deals with how to perform ultrasound examination in the field of Gynecology. I hope this is useful for under graduate students of medicine.TRANSCRIPT
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ULTRASOUND IN GYNECOLOGY
Dr.Suresh Babu Chaduvula
Professor
College of Medicine, KKU,
Abha, Saudi Arabia
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INTRODUCTION Ultrasound was 1st introduced by Ian
Donald in 1950 from Glasgow, UK. Father of ultrasonography – Ian Donald Ultrasonography is commonly used
diagnostic test due to high safety, more acceptance and low cost.
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PHYSICS 3.5 MHz frequency is used in abdominal
ultrasound where as 5-7.5 MHz is used in vaginal type.
Higher is the frequency more will be the resolution of the image but lower will be the depth of tissue penetration.
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INDICATIONS 1. Infertility – for folliculometry and endometrial thickness. 2. Diagnose ovulation time of ovulation 3. Ectopic pregnancy 4. Oocyte retrieval in IVF 5. Ovarian masses like cysts and tumors 6. Uterine fibroid, Tubo-ovarian masses
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7. Oncology- Color Doppler – low impedance and high flow velocity suspects of malignancy.
8. Endometrial diseases – polyps, fibroid, growths
9. Misplaced IUCD 10. DUB or AUB and post menopausal
bleeding 11. Pelvic pain causes 12. Molar pregnancy 13. Malformations of uterus and vagina
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TYPES 1. Trans abdominal 2. Trans vaginal
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TRANSABOMINAL ULTRASOUND Bladder should be full [ Full bladder will
push bowel away from the field- acoustic window]
Explain Consent [verbal] Female attendant [chaperone] Privacy Gentle Brief Gynecological history Examination findings – abdominal and
vaginal
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TRANSVAGINAL ULTRASOUND Bladder full is not needed It has a range of about 8-10 cm. Wear a pair of Gloves Trans-vaginal probe movements: a] Penetrating – introducing into vagina b] Rocking – antero-posterior movement c] Sliding – lateral movement d] Roatating – to 45 to 90 degrees Drawbacks – 1. Virgins 2. Elderly Postmenopausal women 3. Post radiation stenosis 4. Children 5.Psycho-sexual disorder
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FINDINGS OR OBSERVATIONS Identify bladder Uterus size – 6-8X5X4 cm Uterus position – anteverted or retroverted Myometrium Cervix – for growths like polyps or fibroids Endometrial lining Bilateral ovaries Any other adnexal masses – ovarian or
fallopian tubal masses Color Doppler – flow of the blood in a vessel
can be identified Fluid in the Pouch of Douglas
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UTERUS AND ENDOMETRIUM
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ENDOMETRIAL THICKNESS Proliferative phase – 2-4 mm Secretory phase – 5 - 14 mm In post-menopausal women – more than
4 mm warrants or is an indication for biopsy
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FIBROID UTERUS
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INTRA UTERINE COPPER ‘T’
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ADENOMYOSIS OF UTERUS
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CARCINOMA CERVIX
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POLYCYSTIC OVARIAN DISEASE
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ECTOPIC PREGNANCY
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MOLAR PREGNANCY
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ANOMALIES OF UTERUS
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BI-CORNUATE UTERUS
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UTERUS DIDELPHYS
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DERMOID CYST
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Thank You All