This examination should be performed at least once a year, but it would be advisable to have it done at every gynecological visit. According to the recommendations of the Polish Gynecological Society, an ultrasound of the reproductive organs is best performed using a transvaginal probe. This is a thin device that is inserted into the vagina using a disposable sheath. This method provides the most accurate results.
However, there are situations in which such an examination is not possible, e.g.:
- in women who do not consent to a transvaginal examination,
- in women who have not yet had vaginal intercourse,
- in women with vaginal abnormalities,
- in women who have undergone vaginal surgery or radiation therapy.
In such cases, the examination can be performed rectally or transabdominally.
How to prepare for a reproductive organ ultrasound?
- For a transvaginal ultrasound (TV), the patient should empty her bladder.
- This examination is performed on an examination table, with the patient asked to place her clenched fists under her buttocks so that the pelvis is slightly elevated.
- A pelvic ultrasound should be performed between the 5th and 10th day of the cycle (the first day of the cycle is the first day of menstruation), as is the case for women taking sequential hormone replacement therapy. Women undergoing continuous hormone replacement therapy do not need to worry about the day of their cycle during the examination.
- A transabdominal ultrasound of the reproductive organs requires a full bladder. It is recommended that patients drink 1 liter of still water one hour before the exam.
This examination is extremely important and must be performed whenever there are concerning symptoms such as: abnormal bleeding from the reproductive tract, irregular periods, lower abdominal pain, a feeling of fullness, or a lump in the lower abdomen. In addition, regular screening allows for the early detection of many conditions—including endometrial cancer and ovarian tumors.
How often should the exam be performed?
Ultrasound exams during pregnancy are performed at least 3 times, though in practice they are often done more frequently.
- An ultrasound scan up to the 10th week of pregnancy allows us to confirm that the pregnancy is located in the uterus, whether it is a singleton pregnancy, the gestational age, and whether the fetus is alive, as miscarriages are common in the first trimester. This examination is performed using a transvaginal probe. Expectant mothers eagerly await it because they want to confirm whether they are actually pregnant. However, if there are no concerning symptoms, it is best to wait until at least the 6th week of pregnancy (6 weeks from the last menstrual period) to have an early pregnancy ultrasound, as the embryo’s heartbeat cannot be detected earlier, which can cause anxiety for expectant mothers. During the first trimester of pregnancy, it is best to avoid too many ultrasound exams. Until 10 weeks of gestation, the so-called Doppler—or “listening to the fetal heartbeat”—must not be used; at this stage, the heartbeat is visualized in a different, safe manner.
- Ultrasound at 11–13 weeks of pregnancy + 6 days—commonly referred to as the “genetic” ultrasound. This is an extremely important test because it allows for the assessment of the risk of genetic syndromes. It is technically more difficult than a typical scan because it requires the baby to be positioned correctly. It is not uncommon for patients to be asked repeatedly to leave the exam room and walk around, returning for the scan after 20 minutes.
- 18–22-week ultrasound (“mid-pregnancy ultrasound”)—the second most important ultrasound during pregnancy. Like the 12-week scan, it is performed using a transabdominal probe. During the scan, all aspects of the fetus’s development are assessed. This is the time to marvel at the baby’s little feet
- 30-week ultrasound – performed to assess fetal growth
- Ultrasound after 40 weeks – this week, the estimated fetal weight, amount of amniotic fluid, and placenta are assessed.
Women are entitled to all these tests and should insist on them, for the safety of their baby and themselves.
Maja Świetlicka, MD
