Pediatric emergency medicine trisk 4501 4501
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FIGURE 131.15 Longitudinal view of uterus through the bladder. Arrows designate the
potential space of pouch of Douglas posterior to uterus.
An endocavitary probe should be used for the transvaginal approach. Although
the transvaginal transducer is of higher frequency and produces sharper images,
the field of view is more limited. The bladder should be emptied prior to
performing the scan. After the probe is cleaned and covered, it is inserted into the
vaginal canal with the marker facing anteriorly. It often helps to have the anxious
patient insert the probe into the vaginal canal herself. A standard transvaginal
longitudinal view is obtained (Fig. 131.16 ). Once the longitudinal view is
obtained, the probe should be rotated such that the marker is to the patient’s right
to obtain a transverse view. With each planar view, it is important to fan the probe
along the scanning plane axes to visualize the entire body of the uterus. More
experienced sonographers may also be able to visualize the fallopian tubes and
ovaries, but it is important to emphasize that the purpose of the examination is
primarily to determine the presence or absence of an IUP.
