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ultrasound

ULTRASOUND IN GYNAECOLOGY AND OBSTETRICS


Ultrasound seems to be the most commonly advised investigation these days. What are the uses of ultrasound in gynaecology and obstetrics?

Yes, ultrasound is probably one of the most important advances in the field of medicine in the past few years. It gives information about the structure of organs and their relationship to each other. Today, we can study blood flow patterns to various organs and also the ‘hardness’ and ‘elasticity’ of organs.
In gynaecology, ultrasound helps us to measure the size of the uterus, cervix and ovaries and to diagnose any abnormality in these organs. It can tell us if there is fluid or any tumour in the pelvis and also the relationship of the tumour to the various surrounding organs.
Normal fallopian tubes are not seen on ultrasound, however, thickened tubes or tubes filled with fluid or pus or blood; or ectopic pregnancy can be diagnosed by ultrasound.

ultrasound

In gynaecology, ultrasound is commonly used in the following conditions:


Fibroids
– To assess the size, location and number
Ovarian cysts
– To assess the size, number, type (simple, blood filled, benign or malignant)
Infertility
– To assess development of the follicle (egg) throughout the menstrual cycle and also the development of the uterine lining and blood flow patterns to understand ovulation and implantation of the fertilised egg
Endometriosis
– To diagnose chocolate cysts
Irregular/heavy periods
– To measure the thickness of the uterine lining (endometrium) and diagnose polyps or any other abnormalities therein.
PCOS
– To diagnose polycystic ovaries

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In obstetrics, ultrasound is the single most important tool to study the foetus.


Using ultrasound, we can diagnose the following conditions:
• Foetal organs and any abnormality therein – such as heart, brain, kidney or skeletal defects
• Foetal growth – through serial measurements
• Amount of liquor amnii (fluid in the uterus)
• Placenta – whether it is low-lying or abnormal or blood flows are reduced
• Umbilical cord – whether there are loops of cord around the foetal neck or if there are any cord abnormalities
• Blood flow to the foetus can be studied in great details
• Oxygenation of the foetus (whether the foetus is receiving adequate oxygen for brain development and survival) can be studied in high risk pregnancies so that decision can be taken regarding timing of delivery and whether to permit normal vaginal delivery or perform caesarean section
• Assessing the risk for genetic abnormalities such as Down’s syndrome (nuchal translucency assessment)
• Premature shortening or opening of the cervix

Ultrasound is actually ‘seeing’ the organs in question. ‘Seeing is believing’. That means ultrasound is the ultimate tool. It cannot go wrong. Isn’t it?

Unfortunately, that is not true. Ultrasound imaging depends on image quality (which depends on various factors) and the interpretation of the image also depends on many aspects.
There is scope for errors due to various factors.
Thus ultrasound plays an invaluable role in the diagnosis of gynaecological diseases and pregnancy conditions. But you must understand its limitations as well. ultrasound