REPORTING (12/16/2009) : Obstetrics Gynecology BSN 3 Year N1 of St. Dominic

REPORTING (12/16/2009)
OBSTETRICS GYNECOLOGY
BSN 3rd Year N1
of St. Dominic
PREPARED by: Submitted to:
EDUARD L. ALCANTARA MS. ANALINDA SESE, RN,
JENIFER H. ALCORANO MAN
Clinical Instructor
ULTRASOUND
ULTRASOUND
An ultrasound procedure is
a non-invasive (the skin
is not pierced) diagnostic
procedure used to assess
soft tissue structures such
as muscles, blood
vessels, and organs.
ULTRASOUND
Ultrasound uses a transducer that sends out ultrasonic
sound waves at a frequency too high to be heard.
When the transducer is placed at certain locations
and angles, the ultrasonic sound waves move
through the skin and other body tissues to the organs
and structures within. The sound waves bounce off
the organs like an echo and return to the transducer.
The transducer picks up the reflected waves, which
are then converted by a computer into an electronic
picture of the organs or tissues under study.
The Equipment
Types of Ultrasound
1. Image Mood
2. Doppler Mood
Types of Ultrasound (IMAGE
MOOD)
A-mode
Now obsolete in medical imaging. Wave
spikes are represented when a single beam
passes through objects of different
consistency and hardness. The distance
between these spikes (for example A and B)
can be measured accurately by dividing the
speed of sound in tissue (1540 m/sec) by half
the sound travel time.
MOOD)
B-mode ("Brightness")
Same as A-mode, but one-dimensional
graphical display, with brightness
corresponding to amplitude of reflected
sound
MOOD)
M-mode
A single beam in an ultrasound scan can be used to
produce an M-mode picture, where movement of a
structure such as a heart valve can be depicted in a
wave-like manner. Because of its high sampling
frequency (up to 1000 pulses per second), this is
useful in assessing rates and motion and is still used
extensively in cardiac and fetal cardiac imaging.
MOOD)
MOOD)
2D-real time
Most modern ultrasound devices are
2D-real time imaging systems.
Multiple crystals (linear, curved
or phased-array) or moving
crystal.
Sequential B-mode pulses
sweeping across a plane to
display the image in either a
linear or ‘sector’ format.
Displayed as real time imaging
Types of Ultrasound (Doppler
MOOD)
Pulsed-wave Doppler (PW)
Apparent change in received frequency due to
relative motion between a sound source and
sound receiver.
MOOD)
Continuous-wave Doppler (CW)
• Uses different crystals to send and receive the
signal
• One crystal constantly sends a sound wave of a
single frequency, the other constantly receives
the reflected signal
• No depth precision
• Does not alias
MOOD)
Colour Doppler
• Utilises pulsed-echo
Doppler flow
principles to generate
a colour image.
MOOD)
Power Doppler (CPD)
The colour maps for Power are represented by a
single continuous colour
Power does not provide DIRECTIONAL
information, so no aliasing
CPA provides better sensitivity to slow flow states
Less angle dependent than traditional colour
But more sensitive to motion artifact
MOOD)
MOOD)
Directional Power
Doppler
Combines power
(amplitude) of
Doppler signal with
directional (phase)
information
MOOD)
Duplex
Systems or scans which combine imaging and
Doppler with image guidance are often
referred to as duplex systems or duplex
scans.
Kinds of Ultrasound
• Doppler ultrasound - used to see structures
inside the body, while evaluating blood flow
at the same time. Doppler ultrasound can
determine if there are any problems within
the veins and arteries.
• Vascular ultrasound - used to see the
vascular system and its function, including
detection of blood clots.
Kinds of Ultrasound
• Echocardiogram - used to see the heart and its

valves, and to evaluate the effectiveness of the
heart's pumping ability.
• Abdominal ultrasound - used to detect any
abnormalities of the abdominal organs (i.e.,
kidneys, liver, pancreas, gallbladder), such as
gallstones or tumors.
Kinds of Ultrasound
• Renal ultrasound - used to examine the kidneys
and urinary tract.
• Obstetrical ultrasound - used to monitor the
development of the fetus.
Kinds of Ultrasound
• Pelvic ultrasound - used to find the cause of
pelvic pain, such as an ectopic pregnancy in
women, or to detect tumors or masses.
Kinds of Ultrasound
• Breast ultrasound - used to examine a mass
in the breast tissue.
• Thyroid ultrasound - used to see the thyroid
and to detect any abnormalities.
Kinds of Ultrasound
• Scrotal ultrasound
- used to further
investigate pain in
the testicles.
• Prostate
ultrasound - used to
examine any
nodules felt during a
physical
examination.
Kinds of Ultrasound
• Musculoskeletal ultrasound - used to
examine any joint or muscle pain for
conditions, such as a tear.
Kinds of Ultrasound
• Interventional ultrasound - used to help
the surgeon during a minimally invasive
operation or biopsy.
• Intravascular ultrasound (IVUS) - used to
provide direct visualization and
measurement of the inside of blood vessels.
Kinds of Ultrasound
• Endoscopic ultrasound - used to obtain
direct ultrasound examination of the inside
of a body cavity or organ, using an
ultrasound transducer inside an endoscope
(a small, flexible tube with a light and a lens
on the end).
Indications
Ultrasound is used to help physicians evaluate

symptoms such as:
• pain
• swelling
• infection
Indications
Ultrasound is a useful way of examining many of
the body's internal organs, including but not
limited to the:
• heart and blood vessels, including the
abdominal aorta and its major branches
• liver
• gallbladder
Indications
• spleen
• pancreas
• kidneys
• bladder
• uterus, ovaries, and unborn child (fetus) in pregnant
patients
• eyes
• thyroid and parathyroid glands
• scrotum (testicles)
Indications
Ultrasound is also used to:
• guide procedures such as needle biopsies, in
which needles are used to extract sample cells
from an abnormal area for laboratory testing.
• image the breasts and to guide biopsy of breast
cancer
• diagnose a variety of heart conditions and to
assess damage after a heart attack or diagnose
for valvular heart disease.
Before the test
Preparations for an ultrasound test
depend greatly on the type of
ultrasound being performed.
Most ultrasound tests require
little or no preparation. For
ultrasounds being performed on
internal organs, such as the
gallbladder, patients may be
asked to avoid eating or
drinking for six to eight hours
Before the test
However, for other ultrasounds, such as

pregnancy or bladder tests, the patient may be
asked to drink up to six glasses of water prior
to the test to fill the area with extra fluid. The
excess fluid in the bladder helps to move air-
filled bowel loops away from the area of
concern for a clearer view. Rectal ultrasounds
may require an enema to cleanse the bowel
several hours beforehand.
Before the test
Smoking or other use of nicotine can interfere with

ultrasound testing by causing blood vessels to constrict.
A patient may be advised to avoid cigarettes, chewing
tobacco and other nicotine products at least two
hours before the test. Additionally, swallowing air can
alter the results of some ultrasound testing because
ultrasound waves do not pass through air. This is the
reason that ultrasound testing is not commonly used on
the stomach, small intestine or large intestine.
Before the test
In preparation for an ultrasound, it may be helpful to
ask a health care provider about:
• Eating or drinking restrictions prior to the test
• Taking any medications or supplements prior to the
test
• Avoiding soda or other carbonated drinks before the
test
• Wearing loose-fitting, comfortable clothing
• Leaving jewelry and valuables at home
Before the test
• You should wear comfortable, loose-fitting clothing
for your ultrasound exam. You may need to remove all
clothing and jewelry in the area to be examined.
• You may be asked to wear a gown during the
procedure.
• Other preparation depends on the type of examination
you will have. For some scans your doctor may
instruct you not to eat or drink for as many as 12 hours
before your appointment. For others you may be asked
to drink up to six glasses of water two hours prior to
your exam and avoid urinating so that your bladder is
full when the scan begins.
During and After the Test
Most often, ultrasounds are performed

on an outpatient basis, but these tests
are also used in hospitals as part of
diagnostic patient care. In general,
most ultrasounds follow a similar
procedure:
1. Depending on the area being tested, the patient

may lie on a padded examining table during the
test. During the actual test, which normally
takes less than 30 minutes, it may be necessary
to change into a hospital gown, depending on
the area to be examined.
2. A small amount of water-soluble gel, which

acts as a conducer, is placed on the part of
the body to be tested and/or directly on the
transducer, a small device that sends
ultrasound waves through the body. The gel
does not harm the skin or stain clothing. The
ultrasound transducer should not be placed
over an open or draining wound.
3. The technician places the transducer on the
part of the body to be scanned. In some
tests, a probe transducer may be placed
within an opening, such as the vagina or
rectum.
4. The sound waves sent from the transducer
bounce off the structures within the body
and the information is deciphered by the
computer to create the ultrasound images.
5. The ultrasound images then appear on the

television monitor and the moving pictures
can be recorded.
• There is no pain associated with the

ultrasound test. Minor discomfort may be
caused by the pressure of the transducer
against the skin or, in the case of transrectal
or transvaginal ultrasound, the insertion of
the probe in a body cavity.
After the test, the gel is wiped away. The test

is then evaluated by a radiologist, and
results are relayed to the patient’s primary
healthcare provider. If the ultrasound
shows a problem, additional diagnostic
tests, such as an MRI (magnetic resonance
imaging), may be recommended.
RISK
• In extensive studies, no risks associated with properly

conducted medical diagnostic ultrasound have been
documented. These ultrasounds are considered to be
extremely safe, with no harmful side effects associated
with this procedure. Unlike x-rays, there is no exposure
to radiation during an ultrasound. This test is a
noninvasive or minimally invasive procedure that is
widely available, easy to use, inexpensive and causes
little patient discomfort.
RISK
• Ultrasound therapy can pose some risks,

such as burns from misuse. However, such
problems are uncommon when the therapy is
performed by a properly trained healthcare
professional.
Thank you for listening!
“For each petal on the

shamrock this brings a wish
your way. Good health,
good luck, and happiness
for today and every day.” ~
Irish quote

REPORTING (12/16/2009) : Obstetrics Gynecology BSN 3 Year N1 of St. Dominic

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REPORTING (12/16/2009)

• Echocardiogram - used to see the heart and its

Ultrasound is used to help physicians evaluate

However, for other ultrasounds, such as

Smoking or other use of nicotine can interfere with

Most often, ultrasounds are performed

1. Depending on the area being tested, the patient

2. A small amount of water-soluble gel, which

5. The ultrasound images then appear on the

• There is no pain associated with the

After the test, the gel is wiped away. The test

• In extensive studies, no risks associated with properly

• Ultrasound therapy can pose some risks,

“For each petal on the

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