Transvaginal Ultrasound: Purpose, Procedure & What To Expect

What is a transvaginal ultrasound?

A transvaginal ultrasound is an imaging procedure that allows your provider to see your pelvic cavity and the organs inside your pelvis. These organs include your cervix, uterus, fallopian tubes and ovaries. A transvaginal ultrasound can show abnormal structures or growths in your pelvic area that may indicate a condition or disease. Your provider may also order a transvaginal ultrasound to confirm or monitor your pregnancy.

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What is the difference between an ultrasound and a transvaginal ultrasound?

Transvaginal ultrasounds are sometimes called “endovaginal ultrasounds” because the device that records images of your pelvic cavity (transducer) is inserted inside your vagina. The process is different from a traditional abdominal ultrasound, where your provider moves the transducer across your belly to record images.

A transvaginal ultrasound provides a more detailed visual of your organs and the soft tissue inside your pelvic cavity than an abdominal ultrasound. But, an abdominal ultrasound is an option if a transvaginal ultrasound cannot be done. For instance, if you’re pregnant and the placenta (the organ that provides nutrients to your baby) is near your cervix, a transvaginal ultrasound may cause unnecessary bleeding.

When is a transvaginal ultrasound performed?

There aren’t many restrictions or limiting factors when your provider can perform a transvaginal ultrasound. For instance, your provider may order this procedure regardless of whether or not you’re menstruating or pregnant.

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There are limitations If your provider recommends a special kind of transvaginal ultrasound called saline infusion sonohysterography, or a sonohysterogram. A sonohysterogram is when a small amount of fluid is used to distend the cavity of the uterus to allow a good imaging view of the lining. You shouldn't have a sonohysterogram if you’re pregnant or have pelvic inflammatory disease (PID).

When would a transvaginal ultrasound be needed?

Your provider may order a transvaginal ultrasound to diagnose conditions causing unpleasant symptoms, like pelvic pain or abnormal bleeding. Transvaginal ultrasounds can provide further information about abnormalities discovered during a pelvic exam that can lead to a diagnosis. Transvaginal ultrasounds may also be used to monitor your pregnancy.

A transvaginal ultrasound allows your provider to identify:

• Cysts.
• Tumors.
• Fibroids.
• Polyps.
• Signs of a pelvic infection.
• Signs of cancer.
• Signs of ectopic pregnancy or miscarriage.
• Potential causes of fertility issues.
• If an intrauterine device (IUD) is in the correct position.

Your provider may order a transvaginal during pregnancy, especially during the first trimester (weeks one to 12). Your provider may order a transvaginal ultrasound to:

• Confirm your pregnancy.
• Determine how far along you are in your pregnancy.
• Monitor your baby’s heartbeat.
• Identify warning signs of a miscarriage or early delivery.
• Identify conditions that will affect your pregnancy plan, like having a low-lying placenta (placenta previa).

A transvaginal ultrasound can also help your provider plan for surgery.

Who performs a transvaginal ultrasound?

Your provider or a trained specialist called a sonographer, or ultrasound technician may perform the procedure. In some instances, a trained radiologist may perform the procedure and share the results with your provider.