How to perform a gynaecological ultrasound in the paediatric or adolescent patient

Abstract

Ultrasound is the first‐line imaging modality in the assessment of the female reproductive system in all age groups. However, the paediatric and adolescent subset of patients present a particular set of challenges. These include technical challenges that come from largely being limited by transabdominal imaging as well as dealing with the often‐complex social issues around the sexual health of adolescents. In addition, this group of patients has a unique set of pathologies that are not seen in the adult population and conversely, common gynaecological conditions affecting adults such as endometriosis and polycystic ovarian syndrome are difficult to diagnose in adolescents. Therefore, we propose that paediatric and adolescent gynaecological ultrasound requires a different approach. This paper summarises the differences in technique, common pathologies and touches on some of the relevant social issues that are unique to this population of patients.

Accuracy of doppler assessment of the uterine arteries for the diagnosis of pubertal onset in girls: a scoping review

“…The size and morphology of the uterus and ovaries are relatively stable during childhood, and the uterine fundus and cervix have a similar width 30 . During puberty, the uterus increases progressively in size, becoming wider than the cervix, ovarian volume also increases, and multiple cysts can be seen during each menstrual cycle 31 , 32 . Ovarian volume and the quantity of large follicles are generally inferior markers of puberty onset compared with uterine parameters 11 , 33 .…”

Accuracy of Doppler Assessment of the Uterine Arteries for the Diagnosis of Pubertal Onset in Girls: A Scoping Review

“…The size and morphology of the uterus and ovaries are relatively stable during childhood, and the uterine fundus and cervix have a similar width [29]. During puberty, the uterus increases progressively in size, becoming wider than the cervix, ovarian volume also increases, and multiple cysts can be seen during each menstrual cycle [30,31]. Ovarian volume and the quantity of large follicles are generally inferior markers of puberty onset compared with uterine parameters [11,32].…”

Three‐dimensional gynaecological ultrasound, part one: How, when and why?

“…This is valuable in the paediatric and adolescent population. 12 TAS is performed with an abdominal 3D mechanical convex transducer and a full bladder is required to optimise image quality. Gentle pressure should be used to place the endometrium at or near 90 to the ultrasound beam.…”

“…Whilst TVS is the preferred method for 3DUS, if TVS cannot be performed, 3D imaging can be performed via a transabdominal approach. This is valuable in the paediatric and adolescent population 12 . TAS is performed with an abdominal 3D mechanical convex transducer and a full bladder is required to optimise image quality.…”