Gynecological Ultrasound
Ultrasound imaging of the uterus, ovaries, and pelvic structures to investigate abnormal bleeding, pelvic pain, suspected fibroids, ovarian cysts, endometriosis, or infertility.
Overview
Overview
Gynaecological Ultrasound is the primary imaging modality for evaluating the uterus, endometrium, cervix, ovaries, and pelvic structures in women presenting with gynaecological symptoms, pelvic pain, abnormal bleeding, suspected pelvic masses, or fertility concerns. It uses high-frequency sound waves to generate detailed real-time images of pelvic anatomy without any radiation exposure. Transvaginal ultrasound (TVS) provides significantly superior image resolution compared to transabdominal scanning and is the gold standard for endometrial thickness measurement, ovarian cyst characterisation, early pregnancy assessment, and follicle monitoring in fertility treatment. The IOTA classification system provides standardised ovarian cyst reporting to guide appropriate clinical management.
Types of Gynaecological Ultrasound
- Transabdominal pelvic ultrasound — initial overview scan with probe applied to the lower abdomen requiring a full bladder for image quality
- Transvaginal ultrasound (TVS) — thin probe introduced vaginally for superior endometrial and ovarian assessment with significantly better resolution
- Saline infusion sonography (SIS) — saline instilled into the uterine cavity to enhance detection and characterisation of intrauterine polyps and fibroids
- Colour Doppler ultrasound — blood flow assessment in ovarian lesions and uterine vascularity to characterise malignancy risk
- 3D ultrasound — three-dimensional reconstruction for Mullerian uterine anomaly assessment, IUD localisation, and accurate fibroid mapping
Risk Factors of Gynaecological Ultrasound
- Post-menopausal bleeding requiring urgent transvaginal ultrasound to measure endometrial thickness and exclude endometrial carcinoma
- Pelvic pain requiring imaging to exclude ovarian torsion, ruptured ovarian cyst, pelvic inflammatory disease, or ectopic pregnancy
- Infertility assessment requiring baseline imaging to evaluate uterine anatomy, ovarian morphology, and antral follicle count
- Family history of ovarian cancer or confirmed BRCA mutation carrier status requiring annual ovarian surveillance ultrasound
- Suspected intrauterine pathology (polyps, submucosal fibroids) on initial clinical assessment requiring saline infusion sonography
- Positive pregnancy test with lower abdominal pain requiring urgent transvaginal ultrasound to confirm intrauterine pregnancy location
Symptoms of Gynaecological Ultrasound
- Post-menopausal vaginal bleeding of any amount requiring urgent assessment for endometrial pathology or cancer
- Palpable pelvic mass detected on bimanual examination requiring urgent ultrasound characterisation and IOTA risk stratification
- Acute severe pelvic pain with haemodynamic instability suggesting ruptured ectopic pregnancy or ruptured haemorrhagic ovarian cyst
- Chronic pelvic pain, bloating, and urinary frequency suggesting an enlarging ovarian cyst or uterine fibroid
- Heavy and prolonged menstrual bleeding with progressive anaemia suggesting uterine fibroids or adenomyosis on ultrasound
- Cycle irregularity and subfertility suggesting polycystic ovarian morphology or intrauterine pathology on ultrasound
- Dyspareunia (painful intercourse) suggesting ovarian endometrioma, uterine fibroid, or deeply infiltrating endometriosis
- Difficulty conceiving with suspected intrauterine adhesions, polyps, or uterine septum requiring cavity assessment
Key Benefits
Discover the advantages of choosing our gynecological ultrasound services.
TVS provides superior resolution to transabdominal scan for endometrial and ovarian pathology
IOTA classification stratifies ovarian cyst malignancy risk directing appropriate management
Early pregnancy assessment by TVS detects ectopic pregnancy before tubal rupture
Uterine fibroid mapping plans surgical approach before myomectomy or hysterectomy
Follicle tracking in fertility treatment optimises ovulation timing and IVF egg collection planning
Clinical Features
The technology, techniques and clinical approach behind our gynecological ultrasound.
IOTA simple rules applied to all adnexal masses for standardised malignancy risk classification
Endometrial thickness measured in sagittal plane with biopsy referral criteria applied
Transvaginal ultrasound preferred over transabdominal for endometrial and ovarian assessment
Colour Doppler assessment of ovarian cysts characterises vascularity for malignancy risk
Urgent findings communicated to referring clinician immediately
Preparation Instructions
For transabdominal ultrasound drink 1 litre of water 1 hour before the appointment and do not empty your bladder. For transvaginal ultrasound an empty or comfortably full bladder is preferred. Inform the sonographer of your last menstrual period date and any relevant gynaecological history.
The Procedure
Step-by-step guide to what you can expect during your gynecological ultrasound procedure.
Clinical Indication Review and Scan Type Selection
The gynaecologist reviews the clinical indication and determines whether transabdominal transvaginal or saline infusion sonography provides the most diagnostic information for the specific clinical question.
Transabdominal Pelvic Ultrasound
With the patient supine and bladder comfortably full the probe is applied to the lower abdomen. The uterus is surveyed in longitudinal and transverse planes. Both ovaries are identified and measured.
Transvaginal Ultrasound Technique
A thin probe covered with a sterile disposable sheath is gently introduced into the vagina with the patient's consent. TVS provides superior resolution for endometrial assessment ovarian cyst characterisation and follicle tracking.
Endometrial Assessment
The endometrial thickness is measured in the sagittal plane at the maximum thickness. Post-menopausal ET above 4 mm with symptoms triggers endometrial biopsy referral. Polyps or submucosal fibroids are characterised.
Ovarian Cyst Characterisation by IOTA Criteria
Ovarian cysts are characterised by the IOTA classification. IOTA Simple Rules stratify cysts as benign malignant or indeterminate guiding management from surveillance to specialist referral.
Reporting and Communication of Findings
Findings are reported using standardised terminology. Urgent findings are communicated to the referring clinician immediately. The patient is informed of findings at the end of the examination.
What to Expect
For transabdominal scan: ultrasound gel is applied to the lower abdomen and the probe is moved across the skin. For transvaginal scan: a thin probe covered with a disposable sterile cover and gel is gently introduced into the vagina -- this may feel mildly uncomfortable but is not painful. Images of the uterus and ovaries are recorded.
Recovery
Results are typically available within 24 to 48 hours if reported by a radiologist, or immediately if performed by a gynaecologist in clinic. Your gynaecologist will discuss findings and their implications at your clinic appointment. Report any new pelvic pain, heavy bleeding, or other concerning symptoms before your results appointment.
Frequently Asked Questions
Common questions about gynecological ultrasound.
Related Services
Explore other services in our Gynecology & Obstetrics department.
Antenatal Care and Pregnancy Monitoring
Normal Labour and Delivery
Caesarean Section
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