![Page 1: Basic Gynaecolgoy Ultrasound: Basic knowledge](https://reader037.vdocuments.mx/reader037/viewer/2022100222/577cc68e1a28aba7119e9719/html5/thumbnails/1.jpg)
8/12/2019 Basic Gynaecolgoy Ultrasound: Basic knowledge
http://slidepdf.com/reader/full/basic-gynaecolgoy-ultrasound-basic-knowledge 1/51
Chok Chin Nam
Cathy Heng Siang Ting
![Page 2: Basic Gynaecolgoy Ultrasound: Basic knowledge](https://reader037.vdocuments.mx/reader037/viewer/2022100222/577cc68e1a28aba7119e9719/html5/thumbnails/2.jpg)
8/12/2019 Basic Gynaecolgoy Ultrasound: Basic knowledge
http://slidepdf.com/reader/full/basic-gynaecolgoy-ultrasound-basic-knowledge 2/51
Ultrasound
Base on sound wave reflection at the ultrasonicfrequency (2 to 18 megahertz).
Non ionizing, no radiationUltrasound wave produced from transducer reflectedupon hitting tissue echo vibrates the transducer software interpret the sound wave.
Often require bladder window for better accoustictransducibility if TAS is performed.
![Page 3: Basic Gynaecolgoy Ultrasound: Basic knowledge](https://reader037.vdocuments.mx/reader037/viewer/2022100222/577cc68e1a28aba7119e9719/html5/thumbnails/3.jpg)
8/12/2019 Basic Gynaecolgoy Ultrasound: Basic knowledge
http://slidepdf.com/reader/full/basic-gynaecolgoy-ultrasound-basic-knowledge 3/51
Potential uses for ultrasound in gynaecology 1:
Early Pregnancy Loss Assessment of adnexal pelvic masses
Compound B scan Doppler vessel studies
Diagnosis of polycystic ovaries
Investigation of postmenopausal bleeding Imaging and measure of endometrial thickness
Investigation of menorrhagia Fibroids and adenomyosis
Monitoring of follicle number and growth for IVF Egg recovery for IVF and ICSI Evaluation of pelvic pain
A limited role
Screening for ovarian cancer Too many false positives
![Page 4: Basic Gynaecolgoy Ultrasound: Basic knowledge](https://reader037.vdocuments.mx/reader037/viewer/2022100222/577cc68e1a28aba7119e9719/html5/thumbnails/4.jpg)
8/12/2019 Basic Gynaecolgoy Ultrasound: Basic knowledge
http://slidepdf.com/reader/full/basic-gynaecolgoy-ultrasound-basic-knowledge 4/51
Potential uses for ultrasound in gynaecology 2:
IUCD and Implanon location
Treatment of ovarian cysts (aspiration) and ectopicpregnancy (methotrexate)
Saline hysterography for delineation of the uterine cavity
Tubal patency studies in infertility
Evaluation of primary amenorrhoea
![Page 5: Basic Gynaecolgoy Ultrasound: Basic knowledge](https://reader037.vdocuments.mx/reader037/viewer/2022100222/577cc68e1a28aba7119e9719/html5/thumbnails/5.jpg)
8/12/2019 Basic Gynaecolgoy Ultrasound: Basic knowledge
http://slidepdf.com/reader/full/basic-gynaecolgoy-ultrasound-basic-knowledge 5/51
2 types of probe. Abdominal
Lower Frequency
3.5 MHz (2-5 MHz) Penetrate Deeper
Poor Distal Resolution
Large field
The full bladder servesas an acoustic windowand pushes the bowel
out of the sound path
Vaginal
Higher Frequency
7.5 MHz (5-8MHz) 6-8 cm Penetration
Excellent Resolution
Limited field
![Page 6: Basic Gynaecolgoy Ultrasound: Basic knowledge](https://reader037.vdocuments.mx/reader037/viewer/2022100222/577cc68e1a28aba7119e9719/html5/thumbnails/6.jpg)
8/12/2019 Basic Gynaecolgoy Ultrasound: Basic knowledge
http://slidepdf.com/reader/full/basic-gynaecolgoy-ultrasound-basic-knowledge 6/51
Transabdominal TECHNIQUES Supine position
A full bladder willprovide sonographic
window
3.5 MHz curvilineartransducer
Place transducer in the
sagittal plane just abovethe pubic bone
Locate the long-axis ofuterus and sweep fromside to side
Turn transducer 90degrees counter-clockwise
Locate the short-axis of
the uterus and anglecephalad and caudad
Goal is to see the entireuterus
![Page 7: Basic Gynaecolgoy Ultrasound: Basic knowledge](https://reader037.vdocuments.mx/reader037/viewer/2022100222/577cc68e1a28aba7119e9719/html5/thumbnails/7.jpg)
8/12/2019 Basic Gynaecolgoy Ultrasound: Basic knowledge
http://slidepdf.com/reader/full/basic-gynaecolgoy-ultrasound-basic-knowledge 7/51
TRANSVAGINAL TECHNIQUES Supine lithotomy
position
5.0-7.5 MHz
intravaginal transducer Need to apply gel to the
transducer andtransducer cover
Have assistant tochaperone
With locator anterior,scan the long-axis of theuterus
Transducer does notneed to be inserted allthe way to the cervix
Turn transducer 90degrees counter-
clockwise to scan theshort-axis of the uterus
Goal is to see the entireuterus
![Page 8: Basic Gynaecolgoy Ultrasound: Basic knowledge](https://reader037.vdocuments.mx/reader037/viewer/2022100222/577cc68e1a28aba7119e9719/html5/thumbnails/8.jpg)
8/12/2019 Basic Gynaecolgoy Ultrasound: Basic knowledge
http://slidepdf.com/reader/full/basic-gynaecolgoy-ultrasound-basic-knowledge 8/51
Indication Uterine pathology
Adnexal pathology
Bleeding in early pregnancy Ovary phase determination
![Page 9: Basic Gynaecolgoy Ultrasound: Basic knowledge](https://reader037.vdocuments.mx/reader037/viewer/2022100222/577cc68e1a28aba7119e9719/html5/thumbnails/9.jpg)
8/12/2019 Basic Gynaecolgoy Ultrasound: Basic knowledge
http://slidepdf.com/reader/full/basic-gynaecolgoy-ultrasound-basic-knowledge 9/51
Specific types of USG Hysterosonography.
USG Doppler.
![Page 10: Basic Gynaecolgoy Ultrasound: Basic knowledge](https://reader037.vdocuments.mx/reader037/viewer/2022100222/577cc68e1a28aba7119e9719/html5/thumbnails/10.jpg)
8/12/2019 Basic Gynaecolgoy Ultrasound: Basic knowledge
http://slidepdf.com/reader/full/basic-gynaecolgoy-ultrasound-basic-knowledge 10/51
UTERUS
Anteverted uterus: fundus towards same side as bladder
Retroverted uterus : fundus opposite side from bladder
![Page 11: Basic Gynaecolgoy Ultrasound: Basic knowledge](https://reader037.vdocuments.mx/reader037/viewer/2022100222/577cc68e1a28aba7119e9719/html5/thumbnails/11.jpg)
8/12/2019 Basic Gynaecolgoy Ultrasound: Basic knowledge
http://slidepdf.com/reader/full/basic-gynaecolgoy-ultrasound-basic-knowledge 11/51
Uterine pathology Fibroid
Endometrial Hyperplasia
Endometrial Ca Adenomyosis
![Page 12: Basic Gynaecolgoy Ultrasound: Basic knowledge](https://reader037.vdocuments.mx/reader037/viewer/2022100222/577cc68e1a28aba7119e9719/html5/thumbnails/12.jpg)
8/12/2019 Basic Gynaecolgoy Ultrasound: Basic knowledge
http://slidepdf.com/reader/full/basic-gynaecolgoy-ultrasound-basic-knowledge 12/51
Uterine leiomyoma
Transvaginal ultrasound is preferable, but large fibroidmight be better with TAS.
Fibroid is hypoechogenic compare to normalmyometrium.
![Page 13: Basic Gynaecolgoy Ultrasound: Basic knowledge](https://reader037.vdocuments.mx/reader037/viewer/2022100222/577cc68e1a28aba7119e9719/html5/thumbnails/13.jpg)
8/12/2019 Basic Gynaecolgoy Ultrasound: Basic knowledge
http://slidepdf.com/reader/full/basic-gynaecolgoy-ultrasound-basic-knowledge 13/51
Submucosal fibroid
![Page 14: Basic Gynaecolgoy Ultrasound: Basic knowledge](https://reader037.vdocuments.mx/reader037/viewer/2022100222/577cc68e1a28aba7119e9719/html5/thumbnails/14.jpg)
8/12/2019 Basic Gynaecolgoy Ultrasound: Basic knowledge
http://slidepdf.com/reader/full/basic-gynaecolgoy-ultrasound-basic-knowledge 14/51
Endometrial thickening
cyclical change during menstrual cycle
endometrial hyperplasia endometrial polyp
endometrial carcinoma
medications : HRT
![Page 15: Basic Gynaecolgoy Ultrasound: Basic knowledge](https://reader037.vdocuments.mx/reader037/viewer/2022100222/577cc68e1a28aba7119e9719/html5/thumbnails/15.jpg)
8/12/2019 Basic Gynaecolgoy Ultrasound: Basic knowledge
http://slidepdf.com/reader/full/basic-gynaecolgoy-ultrasound-basic-knowledge 15/51
Endometrial polyp
Visual can be enhanced via Doppler.
![Page 16: Basic Gynaecolgoy Ultrasound: Basic knowledge](https://reader037.vdocuments.mx/reader037/viewer/2022100222/577cc68e1a28aba7119e9719/html5/thumbnails/16.jpg)
8/12/2019 Basic Gynaecolgoy Ultrasound: Basic knowledge
http://slidepdf.com/reader/full/basic-gynaecolgoy-ultrasound-basic-knowledge 16/51
![Page 17: Basic Gynaecolgoy Ultrasound: Basic knowledge](https://reader037.vdocuments.mx/reader037/viewer/2022100222/577cc68e1a28aba7119e9719/html5/thumbnails/17.jpg)
8/12/2019 Basic Gynaecolgoy Ultrasound: Basic knowledge
http://slidepdf.com/reader/full/basic-gynaecolgoy-ultrasound-basic-knowledge 17/51
Endometrial thickeningIn the productive period, an endometrial
thickness of up to 14 mm may be considered normal andup to 5 mm post-menopausally
Sign of Endometrial Cancer (HPE exclusion) Higher possibility if ET > 10 mm compare to if < 5 mm
![Page 18: Basic Gynaecolgoy Ultrasound: Basic knowledge](https://reader037.vdocuments.mx/reader037/viewer/2022100222/577cc68e1a28aba7119e9719/html5/thumbnails/18.jpg)
8/12/2019 Basic Gynaecolgoy Ultrasound: Basic knowledge
http://slidepdf.com/reader/full/basic-gynaecolgoy-ultrasound-basic-knowledge 18/51
ENDOMETRIAL SCAN Double wall thickness
measurement (mm)
Immediate 1 - 4
Proliferative 7 - 10
Secretory 8 - 16
![Page 19: Basic Gynaecolgoy Ultrasound: Basic knowledge](https://reader037.vdocuments.mx/reader037/viewer/2022100222/577cc68e1a28aba7119e9719/html5/thumbnails/19.jpg)
8/12/2019 Basic Gynaecolgoy Ultrasound: Basic knowledge
http://slidepdf.com/reader/full/basic-gynaecolgoy-ultrasound-basic-knowledge 19/51
Endometrium Ashermann syndrome
Bands of calcification(hyperechogenic area)
![Page 20: Basic Gynaecolgoy Ultrasound: Basic knowledge](https://reader037.vdocuments.mx/reader037/viewer/2022100222/577cc68e1a28aba7119e9719/html5/thumbnails/20.jpg)
8/12/2019 Basic Gynaecolgoy Ultrasound: Basic knowledge
http://slidepdf.com/reader/full/basic-gynaecolgoy-ultrasound-basic-knowledge 20/51
Adenomyosis Enlarged Uterus
Thickened myometrium
Areas of decreased echogenicity(smooth musclehyperplasia)
Myometrial cystic space(haemorrhagic foci)
![Page 21: Basic Gynaecolgoy Ultrasound: Basic knowledge](https://reader037.vdocuments.mx/reader037/viewer/2022100222/577cc68e1a28aba7119e9719/html5/thumbnails/21.jpg)
8/12/2019 Basic Gynaecolgoy Ultrasound: Basic knowledge
http://slidepdf.com/reader/full/basic-gynaecolgoy-ultrasound-basic-knowledge 21/51
![Page 22: Basic Gynaecolgoy Ultrasound: Basic knowledge](https://reader037.vdocuments.mx/reader037/viewer/2022100222/577cc68e1a28aba7119e9719/html5/thumbnails/22.jpg)
8/12/2019 Basic Gynaecolgoy Ultrasound: Basic knowledge
http://slidepdf.com/reader/full/basic-gynaecolgoy-ultrasound-basic-knowledge 22/51
IUCD LOCALIZATION Proper Positioning
Loss IUCD
Perforation
Not > 20 mmIndicate Proper Positioning
![Page 23: Basic Gynaecolgoy Ultrasound: Basic knowledge](https://reader037.vdocuments.mx/reader037/viewer/2022100222/577cc68e1a28aba7119e9719/html5/thumbnails/23.jpg)
8/12/2019 Basic Gynaecolgoy Ultrasound: Basic knowledge
http://slidepdf.com/reader/full/basic-gynaecolgoy-ultrasound-basic-knowledge 23/51
Adnexal massNormal ovary size 2 × 2 × 3cm
Assessment includeds:
• Mobility
• Septation
• Wall structure• Pain
• Echogenicity
colour Doppler can beuse for :identification ofblood vessels within the
cyst wall and septa, within solid componentsand papillaryprojections.
![Page 24: Basic Gynaecolgoy Ultrasound: Basic knowledge](https://reader037.vdocuments.mx/reader037/viewer/2022100222/577cc68e1a28aba7119e9719/html5/thumbnails/24.jpg)
8/12/2019 Basic Gynaecolgoy Ultrasound: Basic knowledge
http://slidepdf.com/reader/full/basic-gynaecolgoy-ultrasound-basic-knowledge 24/51
Polycystic ovarian disease.
![Page 25: Basic Gynaecolgoy Ultrasound: Basic knowledge](https://reader037.vdocuments.mx/reader037/viewer/2022100222/577cc68e1a28aba7119e9719/html5/thumbnails/25.jpg)
8/12/2019 Basic Gynaecolgoy Ultrasound: Basic knowledge
http://slidepdf.com/reader/full/basic-gynaecolgoy-ultrasound-basic-knowledge 25/51
OVARIAN FOLLICLES (FUNCTIONAL)Phase Follicle Size
Follicular 2- 5 mm
DF (Day 10) 10 mm
Pre-ovulatory 20-24 mm
Corpus Luteum < 30 mm
![Page 26: Basic Gynaecolgoy Ultrasound: Basic knowledge](https://reader037.vdocuments.mx/reader037/viewer/2022100222/577cc68e1a28aba7119e9719/html5/thumbnails/26.jpg)
8/12/2019 Basic Gynaecolgoy Ultrasound: Basic knowledge
http://slidepdf.com/reader/full/basic-gynaecolgoy-ultrasound-basic-knowledge 26/51
Endometriotic cyst
![Page 27: Basic Gynaecolgoy Ultrasound: Basic knowledge](https://reader037.vdocuments.mx/reader037/viewer/2022100222/577cc68e1a28aba7119e9719/html5/thumbnails/27.jpg)
8/12/2019 Basic Gynaecolgoy Ultrasound: Basic knowledge
http://slidepdf.com/reader/full/basic-gynaecolgoy-ultrasound-basic-knowledge 27/51
Ovarian Tumour Characteristic of ultrasonic appearance suggestive of
malignancy:
Multilocular cyst
Solid areas Papillary projection
bilateral lesions
Ascites Intra-abdominal metastases
Large tumour >10cm
Thick, irregular wall
![Page 28: Basic Gynaecolgoy Ultrasound: Basic knowledge](https://reader037.vdocuments.mx/reader037/viewer/2022100222/577cc68e1a28aba7119e9719/html5/thumbnails/28.jpg)
8/12/2019 Basic Gynaecolgoy Ultrasound: Basic knowledge
http://slidepdf.com/reader/full/basic-gynaecolgoy-ultrasound-basic-knowledge 28/51
![Page 29: Basic Gynaecolgoy Ultrasound: Basic knowledge](https://reader037.vdocuments.mx/reader037/viewer/2022100222/577cc68e1a28aba7119e9719/html5/thumbnails/29.jpg)
8/12/2019 Basic Gynaecolgoy Ultrasound: Basic knowledge
http://slidepdf.com/reader/full/basic-gynaecolgoy-ultrasound-basic-knowledge 29/51
![Page 30: Basic Gynaecolgoy Ultrasound: Basic knowledge](https://reader037.vdocuments.mx/reader037/viewer/2022100222/577cc68e1a28aba7119e9719/html5/thumbnails/30.jpg)
8/12/2019 Basic Gynaecolgoy Ultrasound: Basic knowledge
http://slidepdf.com/reader/full/basic-gynaecolgoy-ultrasound-basic-knowledge 30/51
![Page 31: Basic Gynaecolgoy Ultrasound: Basic knowledge](https://reader037.vdocuments.mx/reader037/viewer/2022100222/577cc68e1a28aba7119e9719/html5/thumbnails/31.jpg)
8/12/2019 Basic Gynaecolgoy Ultrasound: Basic knowledge
http://slidepdf.com/reader/full/basic-gynaecolgoy-ultrasound-basic-knowledge 31/51
OVARIAN CYST Dysfunctional Cyst
HemorrhagicCyst/corpus luteum cyst
ConservativeManagement withFollow up 3/12
![Page 32: Basic Gynaecolgoy Ultrasound: Basic knowledge](https://reader037.vdocuments.mx/reader037/viewer/2022100222/577cc68e1a28aba7119e9719/html5/thumbnails/32.jpg)
8/12/2019 Basic Gynaecolgoy Ultrasound: Basic knowledge
http://slidepdf.com/reader/full/basic-gynaecolgoy-ultrasound-basic-knowledge 32/51
DERMOID CYST
![Page 33: Basic Gynaecolgoy Ultrasound: Basic knowledge](https://reader037.vdocuments.mx/reader037/viewer/2022100222/577cc68e1a28aba7119e9719/html5/thumbnails/33.jpg)
8/12/2019 Basic Gynaecolgoy Ultrasound: Basic knowledge
http://slidepdf.com/reader/full/basic-gynaecolgoy-ultrasound-basic-knowledge 33/51
Pelvic inflammatory disease
![Page 34: Basic Gynaecolgoy Ultrasound: Basic knowledge](https://reader037.vdocuments.mx/reader037/viewer/2022100222/577cc68e1a28aba7119e9719/html5/thumbnails/34.jpg)
8/12/2019 Basic Gynaecolgoy Ultrasound: Basic knowledge
http://slidepdf.com/reader/full/basic-gynaecolgoy-ultrasound-basic-knowledge 34/51
![Page 35: Basic Gynaecolgoy Ultrasound: Basic knowledge](https://reader037.vdocuments.mx/reader037/viewer/2022100222/577cc68e1a28aba7119e9719/html5/thumbnails/35.jpg)
8/12/2019 Basic Gynaecolgoy Ultrasound: Basic knowledge
http://slidepdf.com/reader/full/basic-gynaecolgoy-ultrasound-basic-knowledge 35/51
Ectopic pregnancy Abnormal implantation (extra uterine) of the
developing embryo 98% in the fallopian tube (ampullary)
Suspected when thickened endometrial lining (decidua)but without gestational sac (UPT +ve), with free fluid inPOD
Look for yolk sac
Fetal pole and HR outside uterine cavity-confirmthe diagnosis
![Page 36: Basic Gynaecolgoy Ultrasound: Basic knowledge](https://reader037.vdocuments.mx/reader037/viewer/2022100222/577cc68e1a28aba7119e9719/html5/thumbnails/36.jpg)
8/12/2019 Basic Gynaecolgoy Ultrasound: Basic knowledge
http://slidepdf.com/reader/full/basic-gynaecolgoy-ultrasound-basic-knowledge 36/51
A gestational sac outside the uterus with or without fetalheart beat
An adnexal mass which may be echo filled or hypoechoic with an adnexal ring.
A possible decidual cast in the uterus.(pseudosac)
Substantial fluid in the pouch of Douglas or paracolic
gutters or sub hepatic space, due to haemoperitoneuma serum β-hCG greater than 1,500 – 2,000 without
evidence of a gestational sac by transvaginalultrasound represents an ectopic pregnancy
![Page 37: Basic Gynaecolgoy Ultrasound: Basic knowledge](https://reader037.vdocuments.mx/reader037/viewer/2022100222/577cc68e1a28aba7119e9719/html5/thumbnails/37.jpg)
8/12/2019 Basic Gynaecolgoy Ultrasound: Basic knowledge
http://slidepdf.com/reader/full/basic-gynaecolgoy-ultrasound-basic-knowledge 37/51
![Page 38: Basic Gynaecolgoy Ultrasound: Basic knowledge](https://reader037.vdocuments.mx/reader037/viewer/2022100222/577cc68e1a28aba7119e9719/html5/thumbnails/38.jpg)
8/12/2019 Basic Gynaecolgoy Ultrasound: Basic knowledge
http://slidepdf.com/reader/full/basic-gynaecolgoy-ultrasound-basic-knowledge 38/51
Pesudosac vs gestational sac
![Page 39: Basic Gynaecolgoy Ultrasound: Basic knowledge](https://reader037.vdocuments.mx/reader037/viewer/2022100222/577cc68e1a28aba7119e9719/html5/thumbnails/39.jpg)
8/12/2019 Basic Gynaecolgoy Ultrasound: Basic knowledge
http://slidepdf.com/reader/full/basic-gynaecolgoy-ultrasound-basic-knowledge 39/51
Double decidual sign
![Page 40: Basic Gynaecolgoy Ultrasound: Basic knowledge](https://reader037.vdocuments.mx/reader037/viewer/2022100222/577cc68e1a28aba7119e9719/html5/thumbnails/40.jpg)
8/12/2019 Basic Gynaecolgoy Ultrasound: Basic knowledge
http://slidepdf.com/reader/full/basic-gynaecolgoy-ultrasound-basic-knowledge 40/51
![Page 41: Basic Gynaecolgoy Ultrasound: Basic knowledge](https://reader037.vdocuments.mx/reader037/viewer/2022100222/577cc68e1a28aba7119e9719/html5/thumbnails/41.jpg)
8/12/2019 Basic Gynaecolgoy Ultrasound: Basic knowledge
http://slidepdf.com/reader/full/basic-gynaecolgoy-ultrasound-basic-knowledge 41/51
Molar Pregnancy
Snow storm appearance due to vesicles Bilateral theca lutein cyst
![Page 42: Basic Gynaecolgoy Ultrasound: Basic knowledge](https://reader037.vdocuments.mx/reader037/viewer/2022100222/577cc68e1a28aba7119e9719/html5/thumbnails/42.jpg)
8/12/2019 Basic Gynaecolgoy Ultrasound: Basic knowledge
http://slidepdf.com/reader/full/basic-gynaecolgoy-ultrasound-basic-knowledge 42/51
Missed miscarriage Fetal pole > 6 mm with no fetal heart activity.
Gestation sac diameter 20 mm with no fetal poleoryolk sac
Abnormal hyperechoic material
Irregular gestational sac.
![Page 43: Basic Gynaecolgoy Ultrasound: Basic knowledge](https://reader037.vdocuments.mx/reader037/viewer/2022100222/577cc68e1a28aba7119e9719/html5/thumbnails/43.jpg)
8/12/2019 Basic Gynaecolgoy Ultrasound: Basic knowledge
http://slidepdf.com/reader/full/basic-gynaecolgoy-ultrasound-basic-knowledge 43/51
![Page 44: Basic Gynaecolgoy Ultrasound: Basic knowledge](https://reader037.vdocuments.mx/reader037/viewer/2022100222/577cc68e1a28aba7119e9719/html5/thumbnails/44.jpg)
8/12/2019 Basic Gynaecolgoy Ultrasound: Basic knowledge
http://slidepdf.com/reader/full/basic-gynaecolgoy-ultrasound-basic-knowledge 44/51
Complete miscarriage Endometrial thickness <15mm
No evidence of retained tissue
![Page 45: Basic Gynaecolgoy Ultrasound: Basic knowledge](https://reader037.vdocuments.mx/reader037/viewer/2022100222/577cc68e1a28aba7119e9719/html5/thumbnails/45.jpg)
8/12/2019 Basic Gynaecolgoy Ultrasound: Basic knowledge
http://slidepdf.com/reader/full/basic-gynaecolgoy-ultrasound-basic-knowledge 45/51
Incomplete miscarriage•
Heterogenous tissues sac distorting midlineendometrial echo• Any endometrial thickness
![Page 46: Basic Gynaecolgoy Ultrasound: Basic knowledge](https://reader037.vdocuments.mx/reader037/viewer/2022100222/577cc68e1a28aba7119e9719/html5/thumbnails/46.jpg)
8/12/2019 Basic Gynaecolgoy Ultrasound: Basic knowledge
http://slidepdf.com/reader/full/basic-gynaecolgoy-ultrasound-basic-knowledge 46/51
Threatened miscarriage
+ Fetal pole with heart echo
+ IUGS
+/-Subchorionic Haematoma
![Page 47: Basic Gynaecolgoy Ultrasound: Basic knowledge](https://reader037.vdocuments.mx/reader037/viewer/2022100222/577cc68e1a28aba7119e9719/html5/thumbnails/47.jpg)
8/12/2019 Basic Gynaecolgoy Ultrasound: Basic knowledge
http://slidepdf.com/reader/full/basic-gynaecolgoy-ultrasound-basic-knowledge 47/51
Subchorionic haematoma
![Page 48: Basic Gynaecolgoy Ultrasound: Basic knowledge](https://reader037.vdocuments.mx/reader037/viewer/2022100222/577cc68e1a28aba7119e9719/html5/thumbnails/48.jpg)
8/12/2019 Basic Gynaecolgoy Ultrasound: Basic knowledge
http://slidepdf.com/reader/full/basic-gynaecolgoy-ultrasound-basic-knowledge 48/51
![Page 49: Basic Gynaecolgoy Ultrasound: Basic knowledge](https://reader037.vdocuments.mx/reader037/viewer/2022100222/577cc68e1a28aba7119e9719/html5/thumbnails/49.jpg)
8/12/2019 Basic Gynaecolgoy Ultrasound: Basic knowledge
http://slidepdf.com/reader/full/basic-gynaecolgoy-ultrasound-basic-knowledge 49/51
Saline infusion Sonohysterography
(SIS) To detect abnormalities of the uterus and
endometrium
Abnormal uterine bleeding, infertility, recurrentspontaneous miscarriage, congenital abnormalities ofthe uterus, preoperative and postoperative evaluationof the uterine cavity, suspected intrauterine adhesions(synechiae or scar tissue)
Using Insemination catheter 5-15 ml saline into theUterine Cavity
![Page 50: Basic Gynaecolgoy Ultrasound: Basic knowledge](https://reader037.vdocuments.mx/reader037/viewer/2022100222/577cc68e1a28aba7119e9719/html5/thumbnails/50.jpg)
8/12/2019 Basic Gynaecolgoy Ultrasound: Basic knowledge
http://slidepdf.com/reader/full/basic-gynaecolgoy-ultrasound-basic-knowledge 50/51
![Page 51: Basic Gynaecolgoy Ultrasound: Basic knowledge](https://reader037.vdocuments.mx/reader037/viewer/2022100222/577cc68e1a28aba7119e9719/html5/thumbnails/51.jpg)
8/12/2019 Basic Gynaecolgoy Ultrasound: Basic knowledge
http://slidepdf.com/reader/full/basic-gynaecolgoy-ultrasound-basic-knowledge 51/51
Thank you!!!