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4 - Pathology of the uterus, cervix and vagina

Published online by Cambridge University Press:  04 March 2010

Josephine M. McHugo
Birmingham Women's Hospital, Birmingham
Jane Bates
St James's University Hospital, Leeds
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Ultrasound is the appropriate first investigation for the majority of pelvic symptoms in the female. It is however very operator-dependent and when used by appropriately trained personnel with appropriate equipment is cost-effective and safe. Transvaginal scanning is essential to increase the diagnostic accuracy of ultrasound and should be used in all cases unless there is a specific contraindication, such as in the paediatric population. It is essential that transabdominal ultrasound is also performed in order that the large fibroid uterus or other masses can be fully assessed in addition to imaging transvaginally.

There is a need for a meticulous approach to scanning in all cases so that significant pathology is not missed. The sonographer, having completed the ultrasound examination, must then issue an appropriate report. A structured report is also an essential part of the examination and should not only include the biographical details of the patient but also the salient ultrasound findings, both normal and abnormal, followed by either a definite diagnosis if this is possible, or a differential diagnosis.

Further investigations or definitive management can then be arranged.

The sonographer performing the examination should be clearly identified in the report.

A report that is structured in this way will allow retrospective audit of the ultrasound findings relative to operative findings and histology. This audit of accuracy of the ultrasound to histological outcome is essential for best practice.

Publisher: Cambridge University Press
Print publication year: 2006

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