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Uterus

  • Carlo Canepa
  • Lauren Ferrara
Chapter

Abstract

The uterus is a pelvic organ that can be visualized with point-of-care ultrasound and can be helpful in patients with pelvic pain, vaginal bleeding, and newly diagnosed pregnancies. The primary goals of a focused uterus ultrasound are to assess for size, pathology, the location of an IUD, and in the case of pregnancy, an intra-uterine pregnancy. Pathology such as fibroids, cysts, free fluid, ectopic pregnancy, and empty gestational sac can be seen. The test characteristics for ruling out ectopic pregnancy using point-of-care ultrasound are excellent, with a sensitivity of 99.3% and negative predictive value approaching 100% [1]. Point-of-care ultrasound use has been shown to decrease evaluation time in patients being assessed for pregnancy complications [2]. Figures 30.1, 30.2, 30.3, 30.4, 30.5, 30.6, 30.7, 30.8, 30.9, and 30.10 and Videos 30.1, 30.2, 30.3, 30.4, 30.5, 30.6, 30.7, 30.8, and 30.9 provide examples of normal and pathological findings that may be found on transabdominal scanning.

Keywords

Uterus Pelvis Gestational sac Intra-uterine pregnancy Yolk sac Fetus Cervix 

Supplementary material

Video 30.1

This video demonstrates a cranial-caudal sweep through the transverse view of a non-pregnant uterus (MP4 12063 kb)

Video 30.2

This video demonstrates a right-left sweep through a sagittal view of a non-pregnant uterus. Courtesy of Carlo Canepa (MP4 11702 kb)

Video 30.3

This video demonstrates an enlarged non-pregnant uterus with multiple fibroids, scanning right-left. The bladder can be seen caudal to the uterus. Courtesy of Carlo Canepa (MOV 7075 kb)

Video 30.4

A very large non-pregnant uterus is visualized with a very large fibroid. Courtesy of Apichaya Monsomboon (MP4 12029 kb)

Video 30.5

This video demonstrates an intra-uterine pregnancy with two large fibroids. Courtesy of Carlo Canepa (MP4 1068 kb)

Video 30.6

This video demonstrates an early intra-uterine pregnancy with a gestational sac and a yolk sac. It also demonstrates a clear delineation between the endometrium and the myometrium. Courtesy of Carlo Canepa (MP4 719 kb)

Video 30.7

A 16-week fetus can be seen within this enlarged pregnant uterus. Courtesy of Carlo Canepa (MP4 1410 kb)

Video 30.8

An intra-uterine device can be seen within the uterus with ring-down artifact. Courtesy of Carlo Canepa (MP4 11255 kb)

Video 30.9

A uterus can be visualized suspended in free fluid within the pelvi s . Courtesy of Apichaya Monsomboon (MOV 6454 kb)

References

  1. 1.
    Stein JC, Wang R, Adler N, Boscardin J, Jacoby VL, Won G, et al. Emergency physician ultrasonography for evaluating patients at risk for ectopic pregnancy: a meta-analysis. Ann Emerg Med. 2010;56:674–83.CrossRefPubMedGoogle Scholar
  2. 2.
    Blaivas M, Sierzenski P, Plecque D, Lambert M. Do emergency physicians save time when locating a live intrauterine pregnancy with bedside ultrasonography? Acad Emerg Med. 2000;7(9):988–93.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Emergency MedicineHarvard Medical School, Massachusetts General HospitalBostonUSA
  2. 2.Icahn School of Medicine at Mount SinaiNew YorkUSA

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