Guidelines For Professional Working Standards Ultrasound Practice
Guidelines For Professional Working Standards Ultrasound Practice
Guidelines For Professional Working Standards Ultrasound Practice
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2.3 <strong>Guidelines</strong> Relevant To Gynaecological Examinations<br />
The type of examination carried out, i.e. using vaginal (EV) and/or trans-abdominal (TA) techniques should<br />
be directed by the clinical presentation of the patient. As discussed in Section 1.5 a full explanation of<br />
the techniques should be given to the patient and appropriate consent sought. The need for a chaperone<br />
should also be considered. (Refer to Section 1.6).<br />
The sonographer should consider the following:<br />
• obtaining information regarding the patient’s previous medical and menstrual history including stage<br />
and cycle<br />
• establishing information relating to any medication e.g. oral contraceptive pill, hormone replacement<br />
therapy, Tamoxifen<br />
• that EV ultrasound is the recommended technique for detailed assessment of the endometrium<br />
(e.g. referral for post menopausal bleeding) and ovaries (e.g. referral for polycystic ovaries)<br />
• using colour flow mapping and/or power Doppler in appropriate clinical presentations<br />
e.g. the assessment of myometrial vascularity, ovarian angiogenesis, endometrial vascularity<br />
• using 3D ultrasound in the assessment of pathology and congenital malformations of the uterus<br />
and ovaries<br />
Observations<br />
The anatomical structures which the sonographer should normally examine during a gynaecological<br />
examination should be in accordance with the clinical information given and are shown in Table 3. This<br />
should include assessment of size, outline and ultrasound characteristics.<br />
TABLE 3 Structures for Gynaecological <strong>Ultrasound</strong> Examination<br />
STRUCTURE<br />
Uterus<br />
Endometrium<br />
Ovaries<br />
Adnexae<br />
Fallopian Tubes<br />
Pouch Of Douglas<br />
position, size, shape<br />
appearance of the myometrium<br />
appearance and thickness<br />
EVALUATION<br />
position, size, shape, appearance number, size<br />
and internal echo pattern of follicles when present<br />
presence or absence of mass(es). appearance and size when present<br />
assessment where visible<br />
presence or absence of fluid and/or masses<br />
The sonographer should:<br />
• demonstrate the normal anatomy/variants of the female pelvic organs and structures including<br />
age related appearances of each organ in at least two planes<br />
• relate the ultrasound appearances to the relevant menstrual or menopausal status with particular<br />
attention to any patient drug regime<br />
• demonstrate pathological findings and associated haemodynamic findings<br />
• demonstrate the presence of any abnormal intra-abdominal fluid collections or masses<br />
• review the urinary tract when a pelvic mass is identified<br />
27 © UKAS
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