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Hysterosonogram. By: Whitney Pearson. Basic Definitions. Endometrial ablation is the removal or destruction of the endometrium (lining of the uterus). Tubal ligation- Fallopian tubes are surgically cut or blocked off to prevent pregnancy. Hysterosonogram. - PowerPoint PPT Presentation
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HYSTEROSONOGRAM
By: Whitney Pearson
BASIC DEFINITIONS Endometrial ablation is the removal or
destruction of the endometrium (lining of the uterus).
Tubal ligation- Fallopian tubes are surgically cut or blocked off to prevent pregnancy
HYSTEROSONOGRAM A baseline transvaginal ultrasound is first
performed to view the endometrium, including its thickness and any ovarian abnormality.
The doctor then inserts a speculum into the vagina. A small catheter is then inserted and placed directly behind the cervix. The sonographer then inserts the transvaginal probe into the vagina. The doctor will infuse a sterile saline solution into the vagina. The ultrasound will show the saline in the vagina making any abnormalities in the endometrium easy to detect.
It is a valuable technique for evaluating unexplained vaginal bleeding that may be the result of uterine abnormalities such as: polyps, fibroids, scarring, masses or congenital defects.
HYSTEROSONOGRAM SET UP
CASE STUDY
PATIENT HISTORY 34 year old female Gravida 2, Para 0, Abora 2 Symptoms- heavy, irregular bleeding Patient is scheduled for an ablation and
possible tubal ligation A ultrasound guided Hysterosonogram is
first needed to be done before the ablation
BASELINE ULTRASOUND IMAGES
Saggital view of the uterus Transverse view of the uterus
Due to this transverse image of the uterus, the sonographer and radiologist had a suspicion that the patient may have a Bicornuate uterus. This image shows that there may be 2 possible funduses.
A TRANSVAGINAL ULTRASOUND WAS PERFORMED
2 distinct fundus are seen in these transverse images.
Uterus 1 Uterus 2
2 endometrium are also seen
A 3-D IMAGE OF THE UTERUS IS THEN RENDERED TO DEMONSTRATE THE BICORNUATE UTERUS
2 FUNDUS ARE CONFIRMED. THE SONOGRAPHER THEN NEEDS TO SEE IF THE PATIENT HAS 1 OR 2 CERVIX.
This images shows only one
cervix.
1 Cervix
BICORNUATE- UNICALUS UTERUS 2 uterus’s are shown The radiologist describes this as a
Bicornuate-Unicalus uterus. Bicornuate means 2 uterus Unicalus means 1 cervix
CLIP STORES DEMONSTRATING THE FLUID BEING INFUSED INTO THE UTERUS
Catheter
FLUID FLUSHED INTO THE RIGHT UTERUS
FLUID IS FLUSHED INTO THE LEFT UTERUS, A POLYP IS SEEN IN THE FUNDUS
COMPLETE TRANSVERSE SWEEP FROM FUNDUS TO CERVIX
A POLYP IS SEEN IN THE LEFT ENDOMETRIUM
Right Left
BLOOD FLOW IS SEEN WITHIN THE POLYP
FINAL DIAGNOSIS Bicornuate- Unicalus uterus with a polyp
in the left endometrium. The polyp will be removed from the left
Uterus.A Bicornuate- Unicalus uterus does not need
any additional surgery. Both Uterus’s will stay in place.