Ultrasound Examination

What this information covers

In the women's health section, ultrasound serves two purposes: assessing the pelvis in a woman who is not pregnant, and following the sac, heartbeat, placenta and growth in pregnancy. Both can be done with the same machine, but they do not ask the same question.

The abdominal view uses the bladder as a window. Bowel gas blocks the image; a full bladder pushes the gas upwards. The AIUM states that a full bladder is the acoustic window for the pelvis when a transvaginal view is not possible. If the bladder is overfilled, it compresses the uterus and the image deteriorates; the bladder is emptied a little and the view is repeated.

The probe is placed on the abdominal skin with gel. There is no internal view. The procedure involves no radiation. There is no body of evidence showing harm in pregnancy; even so, purposeless, prolonged and high-power scanning is not done.

When is it requested

Urinary complaints, back pain and suspected kidney problems are not the subject of a gynecological ultrasound. If an incidental finding or mass is seen in the bladder, it is noted and referred to urology.

What is assessed in a woman who is not pregnant

The position, size and outer contour of the uterus are seen. Subserosal and large intramural fibroids can be identified through the abdomen. A small polyp protruding into the cavity and the measurement of a thin endometrium may not be reliable with this view. A measurement is not written as a treatment threshold on its own.

An ovary can be lost through the abdomen when it lies behind the bowel. A large cyst, a hemorrhagic cyst and an obvious mass can be seen. Reporting both ovaries as “normal” does not mean that a small focus has been ruled out. A polycystic appearance may give a clue; the diagnosis is made with the history, hormones and examination.

A small amount of fluid in the pouch of Douglas can be normal on the day of ovulation. More fluid together with pain and fever suggests infection or bleeding. The image does not tell them apart.

Pregnancy ultrasound

At the first look there are three questions: is the pregnancy in the uterus, is it alive, and does the gestational age match the history? If the sac is being looked for outside the uterus and cannot be seen through the abdomen, waiting is not enough. An ectopic pregnancy is not always visible through the abdomen. If there is pain, spotting and a positive test, same-day assessment is needed.

Once the heartbeat is seen, the gestational age is roughly recorded using the crown–rump length. This measurement does not replace the date of the last period; if the two do not match, the physician decides which date is used. Twins, an empty sac or a suspected miscarriage are not declared from a single image. In the early weeks, looking again is more correct than a hasty diagnosis.

In the second trimester, the position of the placenta, the amount of amniotic fluid and the baby's measurements are the main tasks through the abdomen. If the placenta lies over the cervix (placenta previa), the bleeding plan changes. A growth curve is not closed as “small” on the basis of a single measurement. A detailed anatomy scan is not what this page offers; its indication and timing are discussed separately.

In the third trimester, presentation, estimated weight and amniotic fluid are followed. Estimated weight has a margin of error. The decision for a caesarean section is not based on a single ultrasound weight.

Preparation

For an abdominal pelvic view, come with a full bladder. Drink water about an hour before the examination and hold your urine. In later pregnancy the baby can open the window itself; the same bladder filling is not required at every check-up. Fasting is not routine for a gynecological ultrasound. If upper abdominal organs are to be examined, you will be told separately for that day.

The gel may feel cold. The examination is painless for most women. If the full bladder causes pressure, the scan is paused, the bladder is emptied a little and the view is repeated. Metal, an IUD and stitches do not prevent ultrasound. If a wound on the abdomen is fresh, the probe is not pressed on that line.

What it does not show

Ultrasound does not replace a smear test. It does not rule out cervical cell changes, the HPV type or cervical cancer. It does not give hormone results. It often misses superficial endometriosis foci. It does not show whether the tubes are open. It does not close an ectopic pregnancy as “absent”. It cannot tell from the image whether a fibroid is cancerous. A report sentence says “seen”; it does not say “this is the disease”.

Doppler is not an ornament added to every pregnancy check-up. Purposeless Doppler screening is not recommended in low-risk pregnancies. If there is suspected growth restriction, high blood pressure or a placental problem, a blood-flow study may be requested separately.

How the result is read

The numbers on the screen are millimetres and weeks. The gestational age is compared with the last period and previous ultrasounds. A single measurement is not a curve. The sentence “a cyst was seen” is not a sentence for surgery. A simple, small cyst without blood flow is usually monitored. Pain, suspected torsion and growth change the follow-up.

The image file may be available in the patient portal. Interpretation is done in person, with the physician. If a report from another centre is brought, the date and measurements are taken into account; the diagnosis is not simply taken over.

Our approach at SoftCare

This page covers abdominal gynecological and pregnancy ultrasound. The transvaginal procedure is described on a separate page; the probe, angle and steps of that technique are not covered here. Sampling and the smear test belong to the laboratory page. Ultrasound does not replace the examination. When pregnancy is suspected, the test and the location are read together. Measurements are written down; decisions are made in conversation.

Listing these sources does not mean that SoftCare uses or reproduces their texts in the same way. Transvaginal ultrasound is also described in these sources; that procedure is not the subject of this page.

Medically reviewed by Op. Dr. Şükrü Sanus, Obstetrician & Gynecologist · Last medical review: 2 October 2026