Sonography

Our USG department is equipped with four state of the art modern color doppler machines in each of our consulting rooms and one 3D-4D Volusion for three dimensional & live 3D (4D) sonography.

What is a Sonogram?

Sonography Introduction

A sonogram, also known as an ultrasound, is a computerized picture taken by bouncing sound waves off organs and other interior body parts. A wand called a transducer is glided along the outside of the body over a centralized area or organ. As it glides, it introduces sound waves into the body. These sound waves bounce off the intended area and back into the transducer, which feeds the information into a computer. The picture then appears on a special computer screen. The sonogram is most often used to monitor a pregnancy.

Sonography Advantages

Because the sonogram uses sound waves and not radiation, it's completely safe.
In addition, a sonogram can offer details X-rays can't.
It's painless and in just about every case, the person receiving the sonogram will not be inconvenienced or made to feel uncomfortable in any way.
Even more important, the sonogram is safe for the unborn child.

Sonography Preparation

There is not too much preparation involved for a sonogram. It's all dependent on the area to be examined. For instance, those who are having an abdominal sonogram may be asked not to eat or drink anything for 24 hours so their doctor can better examine the stomach. A pregnant woman is usually asked to drink lots of water before her sonogram, as it helps the doctor to see the fetus a little better. Loose, comfortable clothing should be worn in order to make the procedure run a little smoother. Other than that, read all the instructions provided by your doctor.

Sonography Applications

In Obstetrics

The USG protocol that is followed in pregnancy includes one 11-13+6 weeks scan as a screening scan which includes an assessment of Nuchal translucency (or NT). NT assessment is a very valuable parameter in early pregnancy and gives the sonologist an opportunity to identify a fetus at risk for trisomy 21, or other chromosomal disorders, and a wide range of genetic syndromes. The 11-13+6 weeks scan also establishes viability, accurate dating of pregnancy and detection of multiple pregnancies.
This is followed by 18-21 weeks 3D-4D anomaly scan for all antenatal mothers. These two scans together can pick up 80-90% of major and minor anomalies in the fetus. In the 18-21 weeks anomaly scan, we visualize all the fetal organs, placenta and liquor in details and also see live 3D-4D images of the unborn child. Pregnancy and organ development of baby is a continuous ongoing process of 9 months and just a single scan is not enough to stamp normalcy of fetal organs.
Hence we follow up in all patients with the growth scan and color doppler at around 28 weeks. Color doppler of umbilical artery, middle cerebral artery, fetal aorta, ductus venosus and maternal uterine arteries with calculation of RI (Resistance Index), PI (Pulsatility Index) and S/D ratio (Systolic/Diastolic ratio) gives an idea of normalcy of blood flow in fetus. Any abnormality in these indices or in blood flow pattern is a pointer towards various pathologies setting in the fetus e.g. IUGR, Brain sparing effect, pregnancy induced hypertension etc.
A sonogram can also detect a multiple pregnancy, giving the doctor as well as the parents enough time to prepare.
With plenty of liquor around the baby, it is easy to see real 3D-4D images of fetus and visualize the in utero movements and activity of the unborn child. Patients are provided with CDs of these movements so that they can enjoy these at home with their families on the computers.
Hence forth, on every visit we subject the patient to growth scan to assess fetal weight, liquor and position of baby.

A sonogram is safe for the pregnant woman and her unborn child even if done very frequently during pregnancy! (unlike an x-ray which is harmful if exposure occurs to the fetus during pregnancy)

In Gynaecology

A sonogram isn't used only to monitor a pregnancy. It can also useful in case of different gynecologic problems like irregular periods, heavy bleeding (menorrhagia), scanty periods, no periods (primary or secondary amenorrhea), lower abdominal or pelvic pain etc.
Transabdominal (TAS) and transvaginal (TVS) sonography are used in evaluation of the female pelvis. In TAS, patient has to fill her urinary bladder. TVS is more useful because of higher frequency transducers with batter resolution. TVS is also useful in patients who are enable to fill their bladders and in obese patients. TVS is also helpful in evaluation of a retroverted uterus, batter distinction between adnexal masses & bowel loops and gives grater detail of the internal characteristics of pelvis mass.
We can diagnose congenital abnormalities of the uterus, abnormalities of the myometrium (fibroid, adenomyosis, arteriovenous malformations etc.), abnormalities of the endometrium (endometrial polyp, endometrial hyperplasia, hydro- hematometrocolpos, endometrial carcinoma, endometritis, endometrial adhesions, intrauterine contraceptive devices, postmenopausal endometrium etc.) and abnormalities of the cervix (nabothian cysts, cervical polyp, cervical fibroid, cervical stenosis, carcinoma etc.).
Sonography is also useful to diagnose ovarian lesions (functional cyst, hemorrhagic cyst, chocolate cyst, parovarian cyst, polycystic ovarian disease, dermoid, ovarian torsion, ovarian cancer etc.), fallopian tube lesions (hydro-pyosalpinx) and pelvic inflammatory disease.
It can also identify the causes of pelvic bleeding and discomfort, find the source of menstrual problems, identify cysts and locate cancerous cells.

In Infertility

Our infertility department, like obstetrics is also incomplete without the valuable aid of USG. Diagnosis of difficult and complicated gynaec pathologies which lead to infertility like endometriosis, adenomyosis, chocolate cysts, fibromyomas, hydrosalpinx & Tubo-Ovarian mass, poly cystic ovaries and ovarian cysts, Pelvic Inflammatory disease, intrauterine and intra pelvic adhesions, Septate uterus, Asherman's syndrome, pelvic abscess and Ectopic pregnancy is possible with great accuracy and certainty by ultrasonography.
It is actually a whole lot of valuable, crucial information which the infertility and IVF specialist can get out of the follicular scans which are done by USG. Ovarian volume, follicular volume and size, peri follicular flow, endometrial thickness and pattern, myometrial echotexture, spiral artery blood flow, uterine artery blood flow and colour doppler; all the doppler indices like Resistance Index, Pulsatility index, Systolic/Diastolic ratio give us an idea of blood flow to endometrium and ovarian follicles. Ovum pick up and embryo transfer is also procedures done exclusively under USG guidance by the IVF specialist.
The most important thing to remember is that a sonogram is routine, safe and painless. While you might be nervous before such a procedure, you'll wonder what you were so worried about when it's over.