SPHP

1. Sag midline uterus. Measure length and AP dimension. Measure endometrial stripe
2. Trans uterus (largest view). Measure width.
3. Sag uterus, right
4. Sag RT ovary, with and without measurement – length and AP dimension
5. Color image and pulse doppler of artery and pulse doppler of vein
6. Trans RT ovary, with and without measurement – width dimension
7. Sag uterus, left
8. Sag LT ovary, with and without measurement – length and AP dimension
9. Trans LT ovary, with and without measurement – width dimension
10. Color image and pulse doppler of artery and pulse doppler of vein
11. Trans vagina
12. Trans cervix
13. Trans body
14. Trans fundus
15. Trans superior to uterus

Both transabdominal and transvaginal exams should be performed unless there is a clinical reason not to perform the transvaginal exam

For endovaginal only exams- Follow the same Guideline for sequence of scanning as below

Uterus:

Sagittal views (right, left, and midline including cervix). Measure length and AP of uterus. Measure endometrial stripe

Transverse views (above uterus, fundus, body, cervix). Measure width.

Ovaries:

Sagittal and transverse views of both ovaries. Measure ovaries in three dimensions. (length and AP on sagittal view, width on transverse view)

Notes:

• measure endometrial stripe in sagittal view, not transverse view. In postmenopausal women, hormonal history important. In premenopausal women, LMP history important
• show abnormalities in sagittal and transverse views, measure in three dimensions (length and AP on sagittal view and width on transverse view

Follicular study (infertility/in vitro)

Follicular measurement. Measurement of follicles greater than 5mm (three dimensions).

Although ovarian torsion is partially a clinical diagnosis, ultrasound findings that can be helpful in the diagnosis include:

transvaginal scanning- look for edematous ovary with peripheral follicles, an associated ovarian mass, ovary in abnormal location, and marked tenderness when scanning directly over the ovary. However, the ovary has a dual blood supply and the presence of flow does not exclude an ovarian torsion. It is necessary to take color and duplex doppler bilaterally of both the artery and the vein.

FOR endovaginal scans following a transvesical scan- Remeasure the endometrial stripe and ovaries. If evaluation of the bladder is also requested, please evaluate bladder as outlined in the “Bladder (only) sonography” protocol.