Diagnostic Ultrasound

Ultrasound (US), also called sonography, is an imaging test that uses sound waves to create pictures of the inside of your body. A small device, called a transducer, sends out high-frequency sound waves that bounce or echo off internal organs. A computer turns those echoes into images on a screen.

Ultrasound is very safe. It does not involve radiation and is painless for most people.

What Types of Ultrasound are Used in Gynecology?

Ultrasound works especially well on soft tissues, which makes it ideal for looking at your:

Uterus
Ovaries
Pelvic organs

It also creates real-time images to show movements like blood flow or a baby moving in the womb.

There are two main types of pelvic ultrasound.

1. Transabdominal ultrasound (TAUS) is a scan done over your lower belly using a gel and an external probe. It gives a good overall picture of the pelvic organs.

2. Transvaginal ultrasound (TVUS). A thin, wand-shaped probe is gently inserted into the vagina to get a closer view of the uterus and ovaries. Transvaginal ultrasound provides more detail than the abdominal scan and is commonly used in gynecology.

Sometimes, both abdominal and transvaginal ultrasounds are done during the same visit to get the most complete view. A Doppler ultrasound may be used during either scan to check blood flow and assess circulation in the:

Uterus
Ovaries
Placenta
Fetus

Why Do I Need a Pelvic Ultrasound?

Your doctor may order a pelvic ultrasound for several reasons. Common uses include:

Abnormal bleeding or irregular periods. An ultrasound can help determine if fibroids, polyps, or other abnormalities in the uterine lining are causing the bleeding.
Pelvic pain or cramping. It helps identify potential causes like ovarian cysts, endometriosis, or infection.
Ovarian cysts or uterine fibroids. Ultrasound can locate and measure cysts or fibroids to help decide whether treatment is needed.
IUD placement. If the strings aren’t visible or your provider wants to confirm the IUD’s position, an ultrasound can be used to locate it.
Infertility evaluation. It’s used to assess the uterus and ovaries, track ovulation, or monitor fertility treatments.
Follow-up on physical findings during a pelvic exam. If your doctor feels something unusual during a pelvic exam, an ultrasound helps identify what’s going on.

What to Expect During the Ultrasound

Transabdominal

For TAUS, you may be asked to drink water before the exam and avoid urinating so your bladder stays full. A full bladder pushes organs into view and improves image quality.

You’ll lie on your back while the technician applies gel to your lower abdomen. The probe is pressed and moved over the skin to capture images. You may feel pressure but not pain.

Transvaginal

For TVUS, you’ll usually be asked to empty your bladder first. You may also be asked to change into a gown.

You’ll lie back with your knees bent. The technician or doctor gently inserts the transducer into the vagina. It’s smaller than a speculum used for a Pap smear, and only the tip is inserted. You may feel a slight pressure or fullness as the probe is moved gently to view the organs from different angles.

After the Ultrasound Exam

The technician will wipe off any remaining gel or give you tissues to clean up.

You can use the restroom and return to your normal activities right away. There is no downtime or recovery needed.

How is Ultrasound Used in Pregnancy?

Ultrasound is used during pregnancy to check on the baby’s development. It’s the same safe technology, just focused on the uterus and growing fetus.

Ultrasound helps confirm the baby’s heartbeat, position, growth, and the placenta. Early in pregnancy, a transvaginal approach is often used because it gives a better view of the small embryo.

Pregnancy ultrasounds are typically done:

Around 6 to 8 weeks to confirm pregnancy and estimate due date
At 18 to 22 weeks for the anatomy scan, where the baby’s growth and organs are checked

A pelvic ultrasound is a simple and safe diagnostic procedure.

Pelvic ultrasound is often the first step in evaluating symptoms like pain or abnormal bleeding. It’s also commonly used to monitor pregnancy and reproductive health. Most exams are quick and easy, and you’ll be guided through the process.