What is the hymen?
A septum that remains in the lumen of the vagina between the urogentital sinus and the upper vagina
What is an imperforate hymen?
Occurs when the hymen does not naturally rupture.
What is Hydrocolpos?
The retention of fluid secretions in the vagina before puberty due to an imperforate hymen.
What is Hydrometrocolpos?
The retention of fluid secretions in the vagina and uterus before menses or after menopause due to an imperforate hymen.
What is Hematocolpos?
The retention of blood trapped in the vagina after puberty due to an imperforate hymen.
What is Hematometra?
The retention of blood trapped in the uterus.
What is Hematometrocolpos?
The retention of blood trapped in the uterus and vagina .
What things do you look for sonographically when assessing the retention of fluid due to an imperforate hymen?
- Identify level of obstruction
- Evaluate the echogenicity (clear = hydro, debris = blood)
- Look for free fluid levels
What are cysts in the vagina called and what are they?
Gartner’s Duct Cysts
Small cysts along the vagina wall that are usually asymptomatic and found incidentally.
Where do Gartner duct cysts originate from?
They are mesonephric duct remnants that are usually on the lateral or anterolateral wall.
How is US used in the diagnosis of vaginal carcinoma?
Not used to diagnose but used to help stage and assess pelvic spread or metastasis.
What are cysts in the cervix called and what are they?
Nebothian cysts
Common retention cysts due to entrapped cervical secretions.
How do you document multiple nebothian cysts?
Document at least one in two planes with measurments and doppler.
How is carcinoma of the cervix Dx?
Clinically with a PAP smear, US used to stage
What obstructions can Ca of the cervix cause?
Hematometra in the uterus or hydronephrosis in the kidneys.
What factors increase the risk of cervical cancer? (8)
- HPV
- Early sexual activity
- Multiple partners
- Low socioeconomic status
- Smoking
- Oral contraceptives
- Weakened immune system
- DES in utero
Sonographic findings of cervical cancer? (8)
- Hematometra from cervical stenosis
- Multiple cystic areas within a solid cervical
mass - Bulky cx
- Irregular cervical boarders
- Mass extending from cervix to pelvic sidewall
- Tumor invasion of the bladder
- Hydronephrosis
- Liver mets and Para-aortic nodes
What are the stages of cervical cancer? (4)
- Confined to cervix
- Extends beyond cervix to the upper two thirds of vagina or parametrial tissue
- Extends to pelvic wall or lower 3rd of vagina
- Extends beyond true pelvis or involves bladder or rectal mucosa
What may happen to the ureters in the presence of Cervix Ca?
Hydroureters (dilated uteters).
What is an incompetent cervix?
A cervix that causes preterm labor (cervical effacement) in the 2nd or early 3rd trimester.
What are the causes of incompetent cervix?
- Trauma
- DES - T shaped uterus
- Idiopathic
What is the best was to assess incompetent cervix?
Translabial/transvaginal
What is DES?
Prescription drug discontinued in 1971
Look at cervix trans labial images
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Module 1: Uterine Pathology75
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Module 2: Ovarian Pathology81
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Module 3: Extra Pelvic Pathology67
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Module 4: Fertility Management76
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Module 4.1: Contraception1
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Module 5: Fetal Neuo Pathology95
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Module 5.1: Fetal Spinal Pathology52
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Module 6: Chromosomal Abnormalities91
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Module 7: Fetal Chest Pathology70
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Module 8: Fetal GI61
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Module 15: Hydrops39
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Module 16: Placental Pathology48
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Module 16.2 GTN52
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Module 17: Nuchal Translucency26
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Module 18: Artifacts2
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Module 9: GU56
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Module 10: Fetal Skeletal Dysplasia's62
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Module 11: Fetal Face and Neck65
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Module 12: Fetal Cardiac Abnormalities57
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Module 13: Multiple Gestation Complications38
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Module 14: Amniotic Fluid19
