Total Care for Women provides obsterical and gynecologic Ultrasound services on site!
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Ultrasound developed in the mid 1970's from simple measurements of body parts to now 3 D computer modeling of body parts. The science is still high frequency sounds waves theat are transmitted through tissues and reflected back to the receiver. Body tissues reflect the minute wave energy back from each tissue interface. With modern computer technology, the direction, intensity and time delays all contribute to form an image that represents the examined body parts. The energy levels are safe and do not cause any worrisome heat to the tissue. Therefore this low level energy will not harm delicate tissues such as early embryonic or fetal tissues. As the imaging has increased in clarity the size of the machines have been reduced to allow construction of very effective office based machines. The machines have become very user freindly as well as very safe for human use. The return or reflected wave energy is now able to be converted to colors as well as pixels for better and enhanced imaging.
Ultrasound imaging is a safe low energy and non x-ray technology that is both hospital and office based systems. This imaging tool has allowed the Ob/GYN physician and radiologist to view internally and sequentailly view/manage many Ob and GYN medical conditions. It is revolutionary as regards to looking into the womb during pregnancy with complete safety - no ionizing x-rays to damage the patient or her unborn child..
Since sound waves vary on return frequency when the sound is relfected off moving structures such as blood, expansion and contractions of arteries and veins, the effect as Doppler shift is used to meassure velocity of living moving body parts. The Doppler shift is the cause of the cound change (frequency) we hear as a train or car for example is approaching and traveling away from our ears! As a result Doppler ultrasouhnd can measure blood flow velocity in the heart, fetal or placental / umbilical artery and veins (two). The health of the heart or placenta can be measured. All this information can be obtained, calculated and displayed without any risk to the patient or if she is pregnant to her baby in the womb.
A Doppler ultrasound is a normal coponent of the compelte Ob ultrasound study.
4 D ultrasound is an advanced spatial modelling generated by composite imaging by ultrasound of the fetus. The computer three demensional modelling creates a life-like spatial model of the fetus. 4 D ultrasound is best performed around 28 - 32 weeks. This study is usually not covered by any insurance program and is not billable to the insurance company. The three dimenional images of the fetus in the womb is These unique studies are cash or credit card only ultrasound studies.
4 D ultrasound of Bella. (She is now one of 15 grandchildren of Dr. and Mrs. James Purdy.) This was taken very early at 25 weeks of pregnancy at Rush Hospital 4 D ultrasound unit.
Ultrasound scanning can be performed by a hand held transducer apparatus. The transducer can image from an external contact on the abdomen or exteranl genitalia (translabial approach or transvaginal approach with the vagina (by vaginal probe insertion) to better image the cervix, uterus and ovaries/fallopian tubes
Who interprets the results?
A local radiologist (physician trained to supervise and interpret radiology examination and ultrasonography) will evaluate the images and send a signed report to Dr.Purdy. Then Dr. Purdy will share the results with the patiemt. In some cases the sonographer with Dr. Purdy may discuss results with you at the conclusion of your examination such as in SIS procedures or OB ultrasound procedures performed at Total Care for Women - eg fetal positioning or cervical length. If the study is performed a Rush Hospital, then the Rush radiologist(s) will report; if the imaging is performed by Dr. Puppa, Dr. Puppa will report by fax. Other scanning locations (Total Care for Women) will send the report to Meridian Imaging.and then forward the report by fax to Dr. Purdy. All reports will be incorporated into the electroinic medical record system by Greenway at Total Care for Women..
Gyn ultrasound can be used to:
Saline infusion sonohysterography or SIS, is a minimally invasive (MIS) ultrasound procedure tha tis routinely performed in the office setting at Total Care for Women. This procedure images the cervix and the endometrial cavity of the uterus. The saline expands the endometrial cavity for better visualization of the endometrial cavity. It is a safe and essentailly minimally uncomfortable procedure to evaluate the condition of the endometrial cavity.
Normal SIS scan
Abnormal SIS scan with polyp
Saline Sonohysterography can check for cause of abnormal bleeding:
This procedure can be combined with an endometrial biopsy. This office procedure can replace the more expensive D&C/Hysterocopy in selected cases as an office based minimally invasive procedure (MIS). The procedure (SIS) takes only a few minutes to complete in the office and the discomfort is minimalized by a small warmed saline injection into the cevix and uterine cavity to outline the cavity by ultrasound. Dr. Purdy and the patient see the imaging immediately. The discomfort is less than a menstrual cramp with the use of analgesic medication (Toradol).
How should I prepare for a SIS procedure?
How is the procedure performed?
How uncomfortable is the procedure? The test may cause some discomfort, such as pelvic or lower abdominal cramping.
Post procedure advise:Contact the nursing staff or Dr. Purdy after the procedure if any of the following symptoms develop:
• Persistent pelvic or abdominal pain
• Difficult or painful urination
• Temperature over 100 degrees
How should I prepare for an abdominal or pelvic ultrasound?
How should I prepare for a transvaginal ultrasound?
What does the equipment look like?
Ultrasound unit like Acuson consist of a console containing a high speed computer that images the reflected ultra high frequency sound generator, a video display screen and a ultrasound transducer that is used to both transmit and receive the the sound waves. The transducer is hand held and can scan the abdomen or the pelvis. The machime transmits varois ultrasound frequency depending on the transducer head array. The higher the frequency, the deeper the sound can penetrate. nner by a cord. IN addition to a hand held traqnsducer, there is a thinner vaginal probe transducer that is long and narrow and it is able to be placed into the vagina to scan the upper genital structures such as the ovaries, fallopian tubes and uterus/endometrium (uterine lining) or posterior back of the pelvis/rectum.
. The ultrasound image is immediately visible on a nearby screen that looks much like a computer or television monitor. The image is created based on the amplitude (strength), frequency and time it takes for the sound signal to return from the patient to the transducer. The portable ultyrasound unit stores the image in computer memory or burns the information to a disc, flash drive or sends it intot he local internetwork for additional viewing elsewhere (virtual radiology).
How does the procedure work?
The final image that we see is the composite of reeived ultrasound waves (yes - sound waves) that are reflected back from the patient's tissue. This the same principle as the naval sonar device or the imaging of fish that the fisherman down the street uses to find his fish in the water. The advanced circuits in the processing unit receives the reflected high frequency sound waves ( too high to hear - hence ultra high frequency sound). The intensity (amplitude), wave direction and transit time determine the size and distance from the reflecting object (tissue planes). The computer uses all the point sof received sound infomration to create pixels that in turn create an image. The iamges when sequenced at rates exceeding 16 frames a second create for us a moving and living image of our bodies. Essentialy, the calcualtions, pixel development is so fast that we perceive the images in real time. The computer can then compare, measure and colorize to create the image, moving images or plot the blood flow velocity. Various formulas of software make the millions of calculations per second to present the data in an image our eyes can transmto to our brains for the mental image we subsequenbtly see! This truly future science concepy is now a everyday reality.- not science fiction of yesteryears. .
In medicine, ultrasound is used to detect changes in appearance of organs, tissues, and vessels or detect abnormal masses, such as tumors.
For most ultrasound exams, the patient is positioned is flat on an exam table. At Total Care for Women, the ultrasound room has a special exam table that change into many orientations for ease of examination and patient comfort.
A clear water-based gel is applied to the area of the body being studied to help the transducer make secure contact with the body and eliminate air pockets between the transducer and the skin. The sonographer then presses the transducer firmly against the skin and sweeps it over the area of interest.
Transvaginal scan needs to be performed. This technique often provides improved, more detailed images of the uterus and ovaries. This method of scanning is especially useful in early pregnancy.
Transvaginal ultrasound is performed very much like a gynecologic exam and involves the insertion of the transducer into the vagina after the patient empties her bladder. The tip of the transducer is smaller than the standard speculum used when performing a pap smear. A protective cover (large condom) is placed over the transducer, lubricated with a small amount of gel, and then inserted into the vagina.
What will I experience during and after the procedure?
After you are positioned on the examination table, the female sonographer at Total CAre for Women will apply some warm water-based gel on your skin and then place the transducer firmly against your body, moving it back and forth over the area of interest until the desired images are captured. The gel will cool and the skin may feel cooler or cold. This is normal. There is no pain with the external examination. The vaginal probe transducer is covered with a large condom before insertion into the vagina. The insertion process should not cause any real pain. It amy feel weird but not pauinfull.
If scanning is performed over an area of tenderness, you may feel pressure or minor pain from the transducer. If an area is pathologic, the area scanned may be uncomfortable to touch. The less probe pressure, the less discomfort. The sonographer varies the pressure of the transducer to reduce any discomfort. The actual ultrasound scanning will not cause any pain.
Once the imaging is complete, the gel will be wiped off your skin.
After an ultrasound exam, you should be able to resume your normal with no down time. This a minimally invasive procedure with no real pain or risks to the patien tor if she is pregnant there is no to the embryo or fetus..