When do gynecological ultrasound on what day. On what day of the menstrual cycle do ultrasound for girls on women's issues

Ultrasound examination of the pelvic organs in men and women can be considered the most informative diagnostic method, which compares favorably not only with its availability, but also with the absence of restrictions on its use. However, in most cases, in order to obtain the most complete information about the state of health of the genitourinary system, represented by a group of organs located in the small pelvis, it is necessary to have a complete understanding of their anatomical and functional features.

The choice of the optimal time when to do a pelvic ultrasound depends entirely on the goals of the study and the organ under study. For example, when diagnosing diseases of the prostate gland in men or the bladder in both sexes, there are no specific requirements for the time of conducting, while the study of the organs of the female reproductive system requires a more thorough analysis of the state of the uterus and appendages with reference to certain days of the menstrual cycle.

Cyclic changes in the uterus and appendages

All processes that cause changes in the uterus are due to the change in phases that occur in the ovaries during the menstrual cycle.

All stages of physiological changes in the uterus and appendages are aimed at creating optimal conditions for the formation and further development of pregnancy and are regulated by several hormones:

estradiol;
luteinizing hormone;
progesterone, etc.

At the same time, hormones have a stimulating effect not only on the growth of the egg, but also on the endometrium - a special type of epithelial cells that cover the inner surface of the uterus and are highly sensitive to hormonal changes. If during the period of formation and development of the follicle (1–10 days of the menstrual cycle) the endometrium is in relative rest, and its thickness is no more than 4–9 mm, then after ovulation, the process of preparing for the appearance of the embryo, that is, the fertilized egg, starts.

During this period, the mucosa begins to thicken, immature cells actively grow, more glands form and blood supply increases. The process is especially intense in the phase of the formation of the corpus luteum and reaches a peak immediately before the onset of menstruation.

The entire process of the formation of a mature endometrium is supported by hormones produced by the follicle, which is in the corpus luteum phase. If fertilization does not occur, it is destroyed (the egg dies) and the entire functional layer of the endometrium is rejected and removed during menstrual bleeding. Simultaneously, the underlying mucosal layer begins to form new cells and a new cycle begins.

Important! The thickness of the endometrial layer is one of the leading factors determining the timing of the study, since in some cases its thickening can veil signs of pathology, and in some, on the contrary, it contributes to its detection.

Indications for ultrasound

The period when it is better to do a pelvic ultrasound depends entirely on the reasons that prompted the woman to undergo an examination. As a rule, diagnostics are performed for the purpose of prevention, during pregnancy, as well as in the presence of symptoms indicating the presence of pathological processes in the genitourinary system of a woman.

As a rule, alarming symptoms should be considered:

heavy bleeding during menstruation (requiring more than 4 pad changes in an hour);
severe pain in the lower abdomen during menstruation or in the second and third phases of the cycle;
irregular periods;
the appearance of spotting at the end of menstrual bleeding, that is, in the middle of the cycle;
infertility.

With the help of ultrasound, it is possible not only to detect diseases such as the formation of myomatous nodes, endometriosis, cystic formations of the ovaries and uterine cavity, but also to systematically monitor the functional activity of the ovaries, from the phase of follicle maturation to ovulation. With a long absence of menstruation, ultrasound can be done at any time, without adhering to the deadlines established for the examination.

Infertility always indicates the presence of pathological processes in the pelvis

Screening ultrasound

As a rule, a planned ultrasound is done in order to timely detect any pathological changes in the genitourinary system of a woman, at a stage when the disease can be seen visually, but the symptoms are not pronounced or absent. The optimal time for screening ultrasound is the beginning of the menstrual cycle, that is, 4-7 days from the onset of menstruation.

During this period, the endometrial layer of the uterus has the smallest thickness, which allows even small neoplasms (polyps, cysts or tumors) to be diagnosed with high accuracy. In addition, at this time, the doctor has the opportunity not only to identify the presence of pathological processes, but also to make a fairly accurate differentiation of the nature of the detected pathology, for example, by the degree of echogenicity, distinguish an endometrioid cyst from a corpus luteum cyst.

It is quite acceptable to conduct a planned study on any other day of the cycle, however, it is important to tell the doctor the exact date of the last menstruation, so during the examination all the results will be analyzed taking into account the changes occurring in the corresponding menstrual phase.

Table: Change in the thickness of the endometrium on ultrasound, in accordance with the days of the menstrual cycle.

Important! Ultrasound should not be done directly on the day of menstruation, since rejection of the functional layer of the endometrium, which occurs in layers or flakes, can lead to distortion of the data obtained.

endometriosis

Endometriosis is a fairly common pathology in which there is an uncharacteristic proliferation of endometrial tissue both within the internal genital organs (uterus, cervix and fallopian tubes) and outside them (peritoneum, bladder or rectum). Depending on the intensity of the current, 4 degrees of development are distinguished:

Single small pockets.
Single deep lesions.
A large number of deep foci, with the formation of small endometrioid cysts in the uterine cavity or on the ovaries.
A large number of deep foci, with the formation of large endometrioid cysts of both ovaries, through germination of the vagina or bladder wall.

Since the initial stages of the development of endometriosis have a blurred symptomatic picture, a targeted study based on the patient's complaints is most often performed when the disease is already at stage 2 of development.

As a rule, an ultrasound examination to detect endometriotic lesions is done 2–4 days before the expected onset of menstruation, that is, on days 24–26 with a 28-day cycle.

Due to the fact that the endometrium is a hormone-sensitive tissue, all pathological foci during this period, regardless of location, increase under the influence of progesterone, which makes it possible to determine the presence of cysts and nodes with high accuracy. Not only a visually detected cyst, but also an uncharacteristic shape of the body of the uterus, which, with endometriosis, can have an asymmetric shape or an uneven echo contour, has a certain information value in making a diagnosis.

In this case, an ultrasound examination should also be done on the 4th–7th day of the cycle, which will allow a comparison to be made whether the uterus has a deliberately irregular shape, or the deformation is caused by endometrial hyperplasia. Despite the fact that ultrasound is often used to diagnose endometriosis, at the initial stages of the development of the disease, ultrasound is not very informative. The most effective and widely used method for diagnosing endometrial hyperplasia can be considered laparoscopy.

In the third phase of the cycle, the endometrioid cyst always increases in size, which greatly facilitates the diagnosis.

Myoma

Myoma is a benign neoplasm that has a rounded shape and consists of chaotically overgrown muscle fibers of the myometrium - the muscle tissue of the uterus. The frequency of diagnosed cases of fibroids is more than 20% of all gynecological diseases, but, according to some reports, the real prevalence of the disease can reach 50%.

As a rule, fibroids have a denser structure than the surrounding myometrium, which is reflected during ultrasound as rounded foci with reduced echogenicity. Depending on the presumed localization of the node, the time of the study also varies.

It is necessary to do an ultrasound of the pelvic organs for the primary diagnosis of the presence of myomatous nodes in the first phase of the menstrual cycle. A thin layer of the endometrium, during this period, allows you to detect even small neoplasms located in the muscular layer of the uterus. On days 11–13, the thickness of the endometrial layer increases, and the information content of ultrasound is significantly reduced.

Thus, fibroids located inside the muscle layer (interstitial) are diagnosed using ultrasound on the 5-7th day of the cycle. To detect fibroids located on the outside of the uterus, it does not matter which day to perform the diagnosis, since the growth of the endometrium inside the uterus does not affect the ultrasound picture of its external contour. Submucosal neoplasms, on the contrary, are well visualized on the 20–25th day of the cycle.

Important! A properly developed tactic for diagnosing fibroids consists in performing an ultrasound scan within the generally accepted time frame, followed by re-diagnosis in the last phase of the cycle to clarify the diagnosis, if submucosal fibroids are suspected.

Monitoring of folliculogenesis

All stages of egg development, from the follicle to the release of a mature egg (ovulation), are called folliculogenesis. With the help of ultrasound, it is possible to monitor the evolution of the follicle and state the presence and quality of ovulation. In addition to monitoring the growth of the egg, a general assessment is made of changes in the reproductive organs of a woman and their compliance with all phases of the cycle.

For monitoring, ultrasound should be done at least 4 times during 1 cycle, and the procedure should be repeated at least 2 cycles in a row. So, the first study is carried out on days 7–10 (with a 28-day cycle). If menstruation is not regular, then the countdown is from the first day of menstruation, performing diagnostics 3 days after they end. With a regular cycle, which, however, has a longer or shorter time period, the time of the first diagnosis is considered 5 days earlier than the established middle of the cycle.

Further sessions are performed at intervals of 2-3 days until the onset of pregnancy or the final formation of the corpus luteum. Simultaneously with the ultrasound examination, it is necessary to take a blood test for hormones, while the doctor analyzes the compliance of the hormone level with the ultrasound data.

The use of transvaginal ultrasound allows you to diagnose ectopic pregnancy in the early stages

Pregnancy

Ultrasound during pregnancy should be done in each trimester, however, this does not exclude the possibility of carrying out the procedure at an earlier date to confirm the fact of pregnancy and exclude the possibility of ectopic localization of the fetal egg. With a transabdominal examination, pregnancy can be diagnosed at 4 weeks, and with a transvaginal one already at 2-3 weeks. The informativeness of the procedure in this case does not depend on the binding to the menstrual cycle and can be done at the time of treatment.

The improvement of ultrasound systems, today, allows them to be used not only in the study of static organs, but also to study dynamically changing systems, for example, the blood supply to the uterus in the surgical treatment of fibroids, by embolization of the uterine arteries. No less valuable is the use of ultrasound in monitoring the placement or removal of the intrauterine device. Three-dimensional echography allows you to get three-dimensional images of detected neoplasms, however, the accuracy of measuring and assessing the quality of these pathologies depends entirely on the competent determination of the timing of the study, determined by the doctor.

How is this study going and why is it so necessary in this crucial period?

The essence of the method of ultrasound (ultrasound) is that the sensor (transducer) generates ultrasonic signals and sends them deep into the human body. There they are reflected from the tissues, then received by the sensor and converted into electrical signals, which, after appropriate processing, are reproduced on the screen of the device in the form of an image.

Purpose of the study

Ultrasound will help to most fully diagnose diseases of the reproductive system and, if possible, treat them before pregnancy. So, for example, in 6-8?% of women, chronic endometritis (inflammation of the uterus) is detected. This can complicate the onset of pregnancy or lead to its complications, so this disease must be cured at the planning stage of the baby. Untimely treatment of diseases of the pelvic organs can lead to irreversible changes in the reproductive system, including infertility.

With the help of modern ultrasound equipment, it is possible to visualize and assess the state of most of the pelvic organs. During the study, the bladder, uterus, ovaries, vaginal section located closer to the cervix, part of the large intestine, as well as the muscles and vessels of the small pelvis are clearly defined.

Abdominal examination

When prescribing this procedure, the attending physician will tell you in detail how to prepare for it and on what day of the menstrual cycle it is better to undergo an examination. It is preferable to do this immediately after the end of menstruation (on the 5-7th day of the cycle) or 1-3 days before it begins. This is the optimal time to detect possible pathological changes.

Ultrasound of the pelvic organs is carried out in two ways: an abdominal sensor (it is placed on the anterior abdominal wall) and vaginal (the sensor is inserted into the vagina).

With an abdominal examination, the procedure is performed in conditions of a filled bladder. To do this, 30 minutes before the procedure, drink 300-500 ml of water without gas or refrain from urinating for 2-3 hours. An adequately filled bladder does not interfere with the inspection of the uterus behind it. If the bladder is empty, examination of the uterus is difficult, as it is difficult to distinguish bladder tissue from the uterus. When using the vaginal method, the examination is carried out with an empty bladder, so it is necessary to visit the toilet before the procedure.

For better ultrasound diagnostics, regardless of the method of examination, it is desirable to empty the intestines. In case of flatulence (bloating), 2–3 hours before the procedure, it is necessary to drink activated charcoal (1–3 tablets): this will reduce the amount of gases in the intestines and facilitate the study.

In addition to the documents, you must take a diaper (towel) with you to the procedure, which you will lay on the couch, and paper napkins to remove a special gel that is applied to the sensor or stomach during the study. The gel is necessary to ensure direct contact between the transducer and the skin for better conductivity of the ultrasound signal. If you are undergoing a procedure in a commercial structure for a fee or under a VHI insurance policy, then a disposable diaper and a napkin are already provided there.

Research progress

During an ultrasound of the pelvic organs, the woman lies on her back on the couch. During abdominal examination, the surface of the skin of the lower abdomen is preliminarily lubricated with a special sound-conducting gel. The procedure is carried out by moving the sensor along the lower abdomen. Before using the vaginal sensor, wipe it with a dry soft cloth or (if dirty) with a cloth slightly moistened with soapy water, and then again with a dry cloth. A sound-conducting gel is applied to the scanning surface of the sensor and a condom is put on it, then the patient is asked to bend her knees and spread them apart a little, after which the sensor is inserted into the vagina.

Ultrasound takes an average of 15-20 minutes, but in complex clinical situations it can last longer. According to the results of the study, an ultrasound diagnostic protocol is filled out, which is given to the patient, and if there is an outpatient card, the ultrasound data is entered into it. If there is no outpatient card, it is desirable that the ultrasound examination protocol be in two copies: one for the doctor, the other for the patient.

Currently, it is preferable to perform ultrasound using a vaginal probe. The advantage of a vaginal examination is the lack of prior preparation and better visualization of adhesions in the pelvic area, with pronounced subcutaneous fat. The disadvantage of this method is the complexity of a full-fledged study of formations larger than 10 cm. In such cases, an ultrasound scan is performed using an abdominal sensor to clarify the situation.

What will the ultrasound of the pelvic organs show?

With ultrasound of the pelvic organs, the doctor assesses the condition of the body of the uterus, cervix, ovaries and their surrounding organs (the fallopian tubes are not normally visualized during the study). The internal structure of organs, changes in their size, shape, the presence of tumor formations are assessed, the thickness of the inner layer of the uterus (endometrium) is measured, other pathological changes are determined that can lead to problems at the stage of preparation for conception or cause complications during pregnancy.

Normally, the uterus is pear-shaped, its length in a woman of childbearing age is on average 5.0 cm (4.5–6.7 cm), thickness - 3.5 cm (3.0–4.0), width - 5.4 cm (5–6.4 cm). The thickness of the endometrium - the inner layer of the uterus (in the form of the study, this parameter is denoted by M-echo) - depends on the phase of the menstrual cycle: on days 5-7, this figure is 4-6 mm, on days 15-28 - 7-14 mm.

Throughout the entire menstrual cycle, the endometrium should be homogeneous. The dimensions of the ovaries in women of childbearing age are on average 3.6 cm long (3.0–4.1 cm), 2.6 cm wide (2.0–3.1 cm), and 1.9 cm thick. cm (1.4–2.2 cm). Normally, in the first days of the menstrual cycle, several follicles with a diameter of 4–6 mm are detected in the ovary; after the 10th day of the cycle, one of the follicles becomes dominant and increases in diameter up to 10 mm. Further, its size becomes even larger, reaching 18–25 mm by the time of ovulation (the release of the egg from the follicle). As the dominant follicle grows, other follicles shrink. After ovulation, the dominant follicle "disappears" or significantly decreases in size. At the same time, a small amount of fluid may be detected in the space behind the uterus. The ruptured follicle grows into capillaries (the smallest vessels) and turns into a corpus luteum, which produces the hormone progesterone. The corpus luteum can only be seen the first few days after ovulation. If fertilization and implantation (attachment of the fetal egg to the wall of the uterus) occurs, the corpus luteum remains and can be detected up to 14 weeks of gestation. Myometrium (muscle tissue) of the body and cervix normally also have a homogeneous structure. Normally, volumetric formations are not detected by ultrasound.

Possible problems

With the help of ultrasound of the pelvic organs, various pathological processes of the organs of the reproductive system in women can be detected:

Anomalies in the development of the uterus and vagina(infantile - underdeveloped, saddle-shaped, bicornuate or unicornuate uterus, uterus with a complete or incomplete septum inside, complete or partial doubling of the genital organs, etc.).

uterine fibroids(a benign tumor originating from the muscular tissue of the uterus) is the most common pathology of the organs of the reproductive system. In the study, you can determine the size of the nodes and the place of their localization. The myomatous node can be located in the thickness of one of the walls of the uterus, protrude on its outer surface or protrude into the uterine cavity, deforming it. The shape of the nodes is correct, rounded or oval, with even, clear contours. A small knot is 8–15 mm in diameter, a medium one is 15–35 mm, and a large one is 35–70 mm. With repeated studies, it is always necessary to determine the size of the nodes: this will determine whether the node is growing and prescribe treatment in a timely manner.

endometriosis- a benign disease characterized by the appearance of the endometrium (the lining of the uterus) outside the inner layer of the uterus.

Tumors and tumor-like formations of the ovaries(benign and malignant). Ovarian cysts occur in women of all ages. When examining the ovary, a rounded formation is determined, the contours of which are clearly visible. The contents of the cyst may be homogeneous or heterogeneous.

Inflammatory diseases pelvic organs, such as tubo-ovarian formations (the so-called single inflammatory conglomerate of the ovary and fallopian tube). In the vast majority of cases, tubo-ovarian formations occur as a complication of the transferred inflammatory process of the fallopian tubes. Also on ultrasound, you can see signs of chronic endometritis: the expansion of the uterine cavity, the presence of gas in it, the heterogeneity of the structure of the endometrium.

Hyperplastic processes of the endometrium- pathological growth of the inner layer of the uterus. With ultrasound, it is defined as the formation of various sizes of increased density and spongy structure, occupying either the entire uterine cavity, or only a small part of it. Signs of a polyp (outgrowth) of the endometrium are formations with clear, even contours that have appeared in the area of \u200b\u200bthe inner layer of the uterus.

Ultrasound is a valuable diagnostic method that allows you to make the correct diagnosis of diseases of the internal genital organs. Based on the data obtained, the doctor decides on the choice of a rational method of treatment, taking into account the nature of the identified pathology. There are no contraindications for this study.

Many are interested in how a pelvic ultrasound goes in women, on what day of the cycle to do the examination, and if there are any contraindications for it.

In gynecology, such an examination is considered basic, that is, its results are basic in relation to other diagnostic procedures.

What features does an ultrasound examination of the pelvic organs have, what can be seen on it, what diseases are diagnosed?

Today, determining the presence of diseases in a person using ultrasound is the most modern and accurate method of research. It is used in almost all areas of medicine, gynecology and obstetrics is no exception.

This method is based on the principle of echolocation of sound (ultrasound is mechanical vibrations of high frequency, and the human ear does not pick them up). They are reflected from the tissues and cavities of the body in different ways. All these processes are displayed on the screen, and the doctor interprets them as different states of internal organs and tissues.

The device's sensor can simultaneously emit and receive waves. But most of the time it is in the receiving mode. Patients should not worry that such radiation is harmful to health.

Moreover, for several decades of the use of diagnostics, not a single case of harmful effects and the development of pathologies from the examination has been noticed. Any allegations that ultrasound diagnostics is dangerous to health are groundless.

Survey methods

Modern methods of conducting such a diagnosis completely exclude pain and discomfort. Doing an ultrasound of the pelvic organs is necessary for all women with suspicions of many diseases of the reproductive sphere.

The following methods of ultrasound diagnostics are used:

Transabdominal examination. The organs located in the small pelvis are examined through the abdominal wall, while the sonologist drives the sensor along the skin of the abdomen, which makes it possible to obtain information about the state of a particular organ. During the procedure, it is necessary that the bladder is full. During the study, the doctor can determine the structural features and structure of the internal genital organs, notice deviations in them, developing formations.
With transvaginal ultrasound, a gynecological examination takes place using a special sensor inserted into the woman's vagina. This diagnostic method makes it possible to examine in more detail the structure of the examined organs, to determine their size.
In combined diagnostics, transabdominal diagnostics is first performed with a full bladder. After it has been emptied, the doctor does a transvaginal examination.
In a transrectal examination, an ultrasound transducer is inserted into the woman's rectum. The method is used in cases where the patient is not yet sexually active.

Indications for examination

Ultrasound of the pelvic organs in women is indicated in the following cases:

Early diagnosis of pregnancy.
Any violations of the monthly cycle (delay, earlier onset of menstruation, the presence of bleeding on days when it should not be, the absence of menstruation, discharge in the lower abdomen of various contents and origin, not associated with menstruation).
Inflammatory gynecological pathologies.
Benign and malignant pathologies of the female genital organs.
Diagnosis of salpingo-oophoritis, endometriosis, ovarian cysts.
Early diagnosis of fibroids.
Monitoring of the follicular apparatus.
Diagnosis of infertility and complex therapy of this disease.
Reception by a woman of contraceptive, hormonal drugs.
The presence of an intrauterine device (ultrasound is done to control the position of the contraceptive and monitor the effectiveness of contraception).
Diagnosis of the causes of urination disorders, diseases of the urethra and other urological pathologies.

When to do an examination

When is the best time to do an ultrasound? Often, not all doctors warn their patients that it is necessary to go for an ultrasound scan on certain days of the cycle. It is best to do an ultrasound between the 5th and 7th day.

This is due to the fact that after the end of menstruation, the structural features of the uterus are easier to determine. This is related to the early phase of proliferation. In this state, you can see a polyp, hyperplasia, determine the exact size of the tumor nodes. At this time, it is possible to accurately exclude the presence of a functional cyst in the patient.

After ovulation, the structure of the uterine mucosa changes significantly and becomes loose. Under such conditions, the doctor cannot notice neoplasms in the uterine cavity, especially if they are in the early stages of their development. At this time, functional cysts can be diagnosed, they do not require treatment, because they disappear with the onset of menstruation.

It is better to do an ultrasound at the beginning of the cycle, in which case it is possible to accurately diagnose the existing pathologies. Women are interested in whether it is possible to conduct such an examination during menstruation? This is not prohibited, and in certain cases, the doctor may prescribe an examination for 2-4 days. Just at this time, the discharge of blood is plentiful. This type of ultrasound is prescribed for patients who are preparing for an extracorporeal examination.

If an ultrasound is done within a few days after the end of menstruation, its results will be more accurate. And to monitor the process of follicle formation, a second ultrasound is done on the 5th, 7th, 9th, 14th and 17th day of the cycle. Depending on the duration of the monthly cycle, shifts in the indicated dates are possible.

What the survey shows

Based on what the doctor sees in the picture, a conclusion is made, and a final diagnosis is made. The sonologist defines:

the position and structure of the uterus, its size, wall thickness;
the presence of follicles and their size;
the presence of foreign formations in the uterus and ovaries;
the presence of foreign objects in the colon and bladder;
other diagnostic important features depending on which organ is being examined.

Deviations from the ultrasonic norm show the presence of disorders in the body. Here are some signs of pathologies that are visible on ultrasound:

thickening of the fallopian tube (this means that a woman has a high risk of developing an oncological process);
if round or oval objects are noticeable, then these are most likely cysts, fibromas;
if the uterus decreases in size, and the ovaries, on the contrary, increase, then this may indicate that the woman has polycystic disease;
changes in echogenicity indicate the presence of uterine fibroids or endometriosis.

The sonologist cannot make an accurate diagnosis. This requires the advice of a specialist. The entire transcript of the ultrasound examination is recorded in the protocol. On its basis, the doctor makes the main conclusion and makes a diagnosis. It is possible to record the entire diagnostic process on a disk, which is used to clarify the diagnosis in doubtful cases.

The main ultrasonic indicators of the norm

It will be interesting and useful for women to know the norm of indicators of the examination of the pelvic organs:

The uterus is normally located in the center of the pelvis, closer to its front wall. If a longitudinal scan is done, then the organ has a pear-shaped shape, and if it is transverse, then it is egg-shaped. Normally, the uterus has an average echogenicity. The internal structure of the uterus is homogeneous, has point and line objects. The size is about 5.2 cm, the body thickness is 3.8 cm, its width is 5 cm.
The ovary cannot always be visualized. Normally, it is oval, with medium echogenicity. Inside there are dot echo-negative inclusions.
The vagina looks like a tubular object that connects to the cervix. If the scan was transverse, then it has an egg-shaped appearance. The normal thickness of the vaginal wall is 3 to 4 mm.
Ultrasound signs of the endometrium vary depending on the monthly cycle. When drawing up the protocol, it is taken into account on which day the ultrasound was done.

If other objects are visible on an ultrasound examination, certain organs change their echogenicity, thickness and other parameters, then this indicates the presence of certain pathologies in the woman's body. In case of questionable results, a woman needs to do other examinations. Most often, the patient may be referred for an MRI or computed tomography. In some cases, a repeat ultrasound may be indicated.

Preparing for diagnostics

Depending on which day of the cycle to do a pelvic ultrasound, the accuracy and effectiveness of the diagnostic procedure depends. However, it will be inaccurate if the patient does not properly prepare for it.

Already a few days before the ultrasound, you need to change your diet and eliminate fiber, legumes and any other foods that cause increased gas formation. It is recommended to warn the doctor about radiography procedures using barium as a radiopaque substance, if they were performed before ultrasound. Sometimes it can significantly affect the results of the diagnosis.

Preparation before the examination includes the following activities:

Before doing, it is necessary to fill the bladder. Approximately 1 hour before the diagnosis, you should drink about 1 liter of water.
Before transvaginal examination, it is necessary to empty the bladder.
Before screening, there are no special recommendations in preparing a woman for an ultrasound scan.

If there are problems with digestion, constipation is disturbing, then it is necessary to take Mezim, Espumizan. With increased gas formation, it is recommended to take several tablets of activated charcoal. On the day of the pelvic ultrasound, it is best not to eat for 10 hours before the procedure. This will ensure accurate test results.

Conducting an ultrasound examination of the pelvic organs is a safe and accurate method of diagnosis, today it is a more accurate and effective treatment. But in order for it to be accurate, and the doctor was able to make the correct diagnosis, one must prepare for it. Incorrect preparation for such an important procedure distorts the results, and the doctor will determine the condition of the organs being examined inaccurately. This, in turn, will lead to improper treatment and other consequences.

In cases where the gynecologist still has questions about the state of a woman's health, studies are prescribed, including ultrasound. It allows you to get a reliable picture of what is happening in the body at the moment. Thanks to modern technologies, it has become possible to detect most diseases at an early stage. Consequently, the quality of the selected treatment regimen is improved, since it will be aimed at solving a specific problem, and not at the symptoms that can provoke it.

Indications for the appointment of diagnostics

What is considered normal

There are certain norms that are usually indicated in the transcript of the results. The average values depend on the age of the patient, the presence of pregnancies, childbirth, the duration of menopause. Normally, the width of the uterus should be within 46-64 mm, thickness - 30-40 mm, length 45-70 mm.

It matters how to conduct and on what day a gynecological ultrasound to measure the thickness of the endometrium. Depending on the day of the cycle, it changes, from a smaller value to a larger one. So, from the first to the fourth day from the beginning of menstruation, it is 1-4 mm, from the fifth to the tenth day - up to 10 mm, from the eleventh to the fourteenth - up to 15 mm, from the fifteenth to the twenty-third - up to 20 mm, from the twenty-fourth and to the end of the cycle - up to 17 mm. The diagnostician during the procedure can also establish the structure of the endometrium, which is anechoic at the beginning of the cycle, hyperechoic at the end. As for the myometrium, it should be homogeneous, without visible pathological inclusions (adenomyosis, fibroids).

Norms M-echo on ultrasound

To determine the state of the endometrium, it is not enough to know its thickness, it is also important to determine its structure. Before the onset of ovulation, an ultrasound diagnostician can determine the degree of growth of the inner layer. It is noteworthy that when the egg is released, it stops growing and begins to compact. If implantation does not occur, then endometrial rejection occurs.

There are certain norms of M-echo, a deviation from which may indicate the presence of deviations. So, to talk about hyperplasia is a thickened and ovoid shape of the inner layer with even and clear contours. In this case, the resistive index deserves special attention. If its value is less than 0.6-0.8 mm, then there is a possibility of developing a neoplasm in the endometrium. An increase in the M-echo by 1-3 mm is also subject to control, provided that its structure is within the normal range.

Deviations from the norm

You should not look for an answer to the question: "Which gynecological ultrasound is better?". Because any method of conducting research can reveal certain deviations. Naturally, modern sensors are highly sensitive and can detect deviations in the photo. Which of these can be determined by ultrasound? For example, anomalies in the development of the genitals, uterus, appendages.

Thanks to this study, you can visually determine its structure. It happens that a woman's uterus has a septum, is divided into two or one part (bicornuate, unicornuate with one fallopian tube), has a very small size or is completely absent (agenesia). Without a gynecological ultrasound, it would be difficult to determine such abnormalities. As well as the presence of fibroids, polyps, endometriosis and others.

When can pregnancy be determined?

Thanks to positive experience and reviews, gynecological ultrasound is safely done already at an early stage of pregnancy. It allows you to determine the location of the fetal egg, to eliminate the risk of developing an ectopic pregnancy. Normally, it should be inside the body of the uterus. At 6-7 weeks of gestation, you can visualize the head, arms, legs, torso of the fetus.

The optimal time for the first study is 10-12 weeks, when it is already possible to determine the fetal heartbeat, the thickness of the collar zone. With a deviation from the norm, there is a risk of developing Down syndrome. Next comes the second screening at 22-23 weeks of gestation, when the likelihood of developing malformations of the internal organs is established or excluded. At this time, you can already determine the sex of the child.

The third screening is sent upon reaching 31 - 32 weeks of pregnancy. At this time, it is possible to determine late deviations in development, the degree of maturity of the placenta, the condition of the child and amniotic fluid. Ultrasound is performed using a transabdominal probe. Intermediate diagnostics are prescribed if there are indications or a deterioration in the state of health of the pregnant woman.

Before conducting ultrasound diagnostics, women are interested in the question of when it is better to do the procedure, on what day of the cycle. Specialists recommend gynecological ultrasound after menstruation is over. Usually it is done no later than on the 7th - 10th day of the cycle. In this case, the countdown begins from the first day of the onset of menstruation.

Indications for uterine diagnostics

Ultrasound of the uterus, ovaries is done by specialists in cases where patients have such symptoms, indicating the presence of diseases of the genital area:

Absence of menstruation;
Infertility;
irregular menstruation;
Pregnancy;
Menstruation, characterized by profusion of discharge, soreness, considerable duration;
The presence of pulling pains in the lower abdomen;
The appearance of bloody discharge between menstruation.

Results of ultrasound diagnostics

Examination of the endometrium using ultrasound waves gives doctors the opportunity to assess the performance of the female reproductive system. After ultrasound, you can detect (if any) the following diseases:

endometriosis;
Hyperplasia of the mucosa;
uterine fibroids;
salpingitis;
Inflammation in various organs of the female reproductive system;
polycystic ovaries;
Pathology on the neck;
ovarian cyst;
Confirmation/denial of pregnancy;
Tumor of the ovaries.

Types of diagnostics

To obtain information about the state of the uterus, all organs of the reproductive system of women in gynecology, the following types of diagnostics are used:

transvaginal examination;
transvaginal examination.

To obtain a clearer picture, the specialist recommends conducting diagnostic methods such as dopplerography, hysterography.

dopplerography

This diagnostic method is done in order to measure the movement of cells, as well as the speed of blood flow inside the vessels. It is prescribed in parallel with ultrasound diagnostics if there are suspicions of possible neoplasms. These studies contribute to the scheduling of blood flow in the direction of the pelvic organs. Doppler mapping, Dopplerography allows the doctor to better examine the endometrium of the uterus, detect all kinds of pathological changes, and visualize ovarian function.

Hysterography

Provides clinicians with a clear view of organs from the genitourinary system. For its implementation, a contrast agent is used. It is inserted into the vagina. The method is used mainly if a specialist suspects that a woman has a malignant gynecological disease (cancer, fibroids).

When is the best time to perform an ultrasound of the uterus?

Why is it better to perform the survey during this period of time? Because the endometrium in these days of the cycle becomes as thin as possible. If any pathologies are present inside the organ, a specialist will determine their presence through ultrasound. With thin epithelium, it is better to consider the following anomalies:

Myoma;
The presence of polyps;
Hyperplasia.

On what day of the cycle does the endometrium thicken? Thickening of the endometrium is noted in the second part of the cycle. Gynecological ultrasound these days is not recommended, its information content will be very low in the same way as its accuracy. After thickening of the mucous membrane, the sonologist may not notice small polyps that are hidden in the thickness of the epithelium.

Also, the second half of the cycle is characterized by the process of maturation of the follicle. Therefore, during this period, during the diagnosis, cysts are detected, the diameter of which is 2–3 cm. Such a cyst is a normal physiological structure. It is a follicle that will soon ovulate, as well as a cyst of the corpus luteum.

Also inside the uterus, you can find small cysts, the size of which reaches 7 - 12 mm. Their presence is determined at the end of the menstrual cycle, in the first days after the onset of menstruation (3-5). It is impossible to distinguish such cysts from pathological ones.

In order for the specialist to appoint an ultrasound examination in the middle, the second part of the cycle must be a definite need. It may be the observation of a specialist over the process of maturation of the follicle to confirm ovulation. Similar examinations are carried out for those women who are observed by an obstetrician-gynecologist due to infertility.

During the period of menstruation, gynecological ultrasound is not done (only after it). There is blood inside the uterine cavity, which does not allow the specialist to examine its internal cavity these days. But it is quite advisable to diagnose the walls of the uterus and ovaries at this time.

Preparing for diagnostics

Gynecological ultrasound is performed by various methods. Depending on the type of ultrasound diagnostics, the doctor prescribes preparation for the procedure. Proper preparation for diagnosis affects the reliability of the examination.

Transvaginal ultrasound

It is carried out on the 5th - 7th day of the cycle. For diagnosis, a special sensor is inserted into the vagina, which is brought to the uterus. This is how the genitals are scanned.

A day or two before the procedure, it is necessary to exclude products that can cause excessive gas formation inside the intestines.
It is also desirable to conduct a cleansing enema.
The patient's bladder should be adequately filled.

echohysterosalpingoscopy

This diagnosis is performed before the 10th day of the cycle, in the case when the menstrual cycle is 28 days. Through this study, the patency of the fallopian tubes is checked. The examination consists in introducing liquid under slight pressure into the fallopian tubes. With normal patency, fluid freely penetrates into the retrouterine space.

Preparation is similar to preparing for a transvaginal ultrasound.

Transabdominal ultrasound

It is also carried out on the 5th - 7th day of the cycle. Diagnostics is performed through the abdominal wall. The bladder should be full and the patient may feel a slight urge to urinate.

You need to follow an appropriate diet, exclude foods that cause the formation of gases inside the intestines. It should be followed for 2 days before the procedure.
It is necessary to carry out a cleansing enema in the absence of a chair on the eve of the examination.
The bladder must be full before the ultrasound.

Ultrasound during pregnancy

Before the first scheduled examination, the main thing is to fill the bladder and exclude gas-producing foods from the diet.
Before the diagnosis of the second, third trimester, the bladder may be empty. But if a woman's previous pregnancy was resolved by caesarean section, the urea must be completely full.

Stages of ultrasound in gynecology

Gynecological ultrasound examination can be performed as an independent diagnosis, as well as during examination by an obstetrician-gynecologist. The examination is carried out transvaginally for a more thorough examination of the condition of the uterus. The procedure consists of several stages:

Emptying the bladder before performing the diagnosis. It is necessary to remove clothes worn below the waist.
To conduct an examination using a vaginal probe (abdominal), it is necessary to put a special condom on it, then apply a gel to facilitate the passage of ultrasonic waves. The sensor has the form of an elongated cylinder with a diameter of 2 - 2.5 cm.
After inserting the probe into the vagina, a scan is performed, which takes approximately 10 to 20 minutes.
In the process of diagnosis, the doctor takes pictures that other specialists can get acquainted with the patient's medical history.

After the diagnosis, the specialist receives data on the state of the uterus, all organs of the female reproductive system. The interpretation of the results is performed by an obstetrician-gynecologist.