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Comprehensive Ultrasound in Obstetrics & Gynaecology

This guide covers various ultrasound indications in obstetrics and gynaecology, from first trimester bleeding to gynaecological issues like fibroids and ovarian cysts. Learn when and how ultrasound is used in different stages of pregnancy and for gynaecological concerns.

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Comprehensive Ultrasound in Obstetrics & Gynaecology

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  1. Ultrasound in Obstetrics and Gynaecology Dr Bhanu Deval MBBS MS MRCOG PgCObs and Gynae Ultrasound

  2. Obstetric Ultraound Indications-First Trimester • Bleeding • Pain • Previous ectopic • Hyperemesis • Previous molar pregnancy • Bad obstetric history

  3. Intrauterine Pregnancy

  4. Complete Miscarriage

  5. Incomplete Miscarriage

  6. Missed Miscarriage

  7. Ectopic Pregnancy

  8. Indications Second Trimester • NT Scan • Chorionicity • Cervical length surveillance • Previous extreme pre term delivery <28weeks • Previous cone biopsies/multiple LLETZ • Multiple pregnancy • Known uterine anomaly • Morphology scan • Fetal Echocardiogram • Previous baby with congenital cardiac anomaly • Diabetic women • Epilepsy-medicated • Women with known cardiac anomaly

  9. Indications Third Trimester: • Growth Scans with UA/MCA dopplers • Presentation • Post Dates-AFI

  10. Indications Growth Scans Pregnancy related: • Multiple pregnancy-DCDA from 28weeks onwards • Multiple pregnancy-MCDA from 24 weeks onwards • PET • Reduced SFH • Known IUGR • APH-Placenta praevia, abruption • Recurrent APH of unknown cause • GDM Pre existing: • Obstetric History: SB, Previous IUGR, Previous abruption • Smoking/substance abuse • Pre existing medical conditions-Thrombophilias, APLS, SLE, autoimmune conditions, renal disease, hypertension, severe asthma, thyroid disorders • BMI>35

  11. Indications Post partum/post miscarriage Abnormal bleeding/Secondary PPH • RPOCs • Endometritis • Molar pregnancy • Placental site trophoblastic tumours • AV malformations

  12. Gynaecological Ultrasound Indications: Menorrhagia+/-dysmenorrhoea Oligomenorrhoea/Amenorrhoea Pelvic pain Pelvic mass Subfertility Post menopausal bleeding Misplaced Mirena/IUCD

  13. Menorrhagia • Fibroids • Endometrial polyps • DUB Menorrhagia with Dysmenorrhoea • Adenomyosis/endometriosis • PID

  14. Oligomenorrhoea/Amenorrhoea Primary • Uterine agenesis- RMK syndrome • Imperforate hymen • Mullerian abnormalities- Vaginal septum +/- other uterine abnormalities • Gonadal dysgenesis(Turner’s): Streak ovaries • GnRHa deficiency: Kallmann’s Syndrome

  15. Oligomenorrhoea/Amenorrhoea Secondary Hypothalamic/hypopituitary • Anorexia/Bulimia • Stress • Pituitary tumours • Sheehan’s syndrome • Thyroid dysfunction Ovarian: • PCOS • POF Uterine: Asherman’s Syndrome

  16. Pelvic pain • Adenomyosis/endometriosis-Ovarian endometriomas • PID • Ovarian cyst accidents-Haemorrhage/rupture/torsion Simple cysts do not cause pelvic pain!

  17. Pelvic Mass • Fibroid • Ovarian cysts • Pre menopausal-simple/complex • Post menopausal-simple/complex

  18. Subfertility Ovaries: • Ovarian reserve-AFC, AMH • PCOS • Endometrioma • Peri ovarian adhesions/fixity • Ovarian blood flow • Access Adnexal: • Hydrosalpinx-PID • Peri tubal/intra peritoneal adhesions Uterine: 3D scan • Submucous fibroid/endometrial polyps • Adenomysosis-EMZ disruption, POD fixity Unexplained

  19. Decline in Ovarian Reserve – using AFC and AMH Antral Follicle Count Anti Mullerian Hormone

  20. PMB • Atrophic endometrium • Endometrial Hyperplasia/Polyps • Endometrial CA • Ovarian cysts • Clinical examination –CST.

  21. Ultrasound in Obstetrics and Gynaecology • When? • What?

  22. Thank You!! 

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