Bedside Obstetric/Gynecologic Ultrasonography

imagesIs an intrauterine pregnancy (IUP) (defined as yolk sac or fetal pole) present?


imagesAbdominal or pelvic pain


imagesSuspected ectopic pregnancy or risk factors for ectopic pregnancy


imagesVaginal bleeding


imagesUnexplained syncope, or hypotension


imagesPelvic mass


CONTRAINDICATIONS



imagesAbsolute: None


imagesRelative (transvaginal approach): Recent major pelvic surgery


CONSENT



imagesGet verbal or written consent for the procedure, except in extremis situations


RISKS



imagesNo documented harmful effects on the fetus or the mother due to ultrasound exposure


LANDMARKS



imagesTransabdominal


   imagesHave the patient lie supine


   imagesThe bladder should be full in order to have an adequate acoustic window


   imagesUse a standard curved 3.5- to 5.0-MHz probe to scan the lower abdomen


   imagesPlace the probe on the anterior abdominal wall, at the level of the symphysis pubis


   imagesFor advanced gestations, place the probe more proximally


imagesTransvaginal


   imagesInsert the probe into the vaginal canal


   imagesThe uterus is midline, posterior to the bladder and anterior to the rectum (FIGURE 44.1)


   imagesThe right and left ovaries are lateral to the uterus and anteromedial to the right and left iliac vessels


   imagesAnteroflexed uterus 90% and retroflexed in 10%



images


FIGURE 44.1 Transvaginal views of the uterus. A: Sagittal view. B: Transverse view.

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Aug 9, 2016 | Posted by in EMERGENCY MEDICINE | Comments Off on Bedside Obstetric/Gynecologic Ultrasonography
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