Transvaginal scan (TVS) in pregnancy

A transvaginal ultrasound scan is done via the vagina. Early pregnancy scans are often done this way because, at this stage, your baby is too low down to be seen well through the abdomen. A TVS can help confirm your pregnancy, predict your due date, check your baby's heartbeat, pick up an ectopic pregnancy and show if you're carrying one baby, twins, or more. A TVS gives a much clearer picture and may be advised at any stage of pregnancy if needed. The scan isn’t painful, but if you feel any discomfort, let your doctor know.

What is a transvaginal ultrasound scan (TVS)?

A transvaginal scan, also known as an internal or endovaginal ultrasound scan, is done via the vagina. Your ultrasound doctor will gently put a long, narrow probe called a transducer inside your vagina.

High-frequency sound waves emitted from the probe bounce off your baby and are captured by the probe again to produce a detailed image of your baby on a computer screen. This image allows your doctor to determine if all is well with your pregnancy and your unborn baby.

On average, the scan will take about less than 10 minutes.

What is the difference between a transvaginal and transabdominal scan?

• Transvaginal means "through the vagina." The transvaginal scan is a slightly invasive, internal ultrasound as the ultrasound doctor inserts the transducer to about two to three inches into the vagina. You don’t need a full bladder for a TVS.
• Transabdominal means "through the abdomen". The transabdominal scan isn’t invasive as the transducer is placed on the abdomen. Scanning is done by pressing the transducer firmly against the skin of the abdomen. Your bladder needs to be full for this scan.

The type of scan you need depends on the reason for the ultrasound as well as your stage of pregnancy.

Usually, only one kind of scan is needed at an appointment. However, in some cases, both methods may be required if your doctor needs more information for the diagnosis or treatment.

Generally, transvaginal scans provide a better close-up and are more detailed. However, your doctor may recommend an abdominal ultrasound if a TVS cannot be done for some reason.

When and why is a transvaginal scan done during pregnancy?

If your doctor wants you to have a scan earlier than 10 weeks of pregnancy, she's likely to recommend a transvaginal scan. This is because, in early pregnancy, your baby is too small and too low in your abdomen to be seen clearly by an abdominal scan.

A transvaginal scan also gives a clearer image of your uterus and surrounding organs.

Transvaginal scans between six and 10 weeks of pregnancy

You'll most likely be offered a transvaginal scan when you're between six weeks and 10 weeks pregnant. Some of the reasons include:

• To confirm your pregnancy and predict your due date, also known as your estimated date of delivery (EDD).
• Your baby's heartbeat isn't seen on an abdominal scan.
• To check for an ectopic pregnancy.
• You have a history of miscarriage.
• You are in pain or have bleeding. in early pregnancy.
• Your doctor suspects multiple pregnancies.
• You are pregnant after fertility treatments.

Transvaginal scans after 10 weeks of pregnancy

After 10 weeks and for the rest of your pregnancy, you will likely have abdominal scans because once your uterus expands and moves up in your abdomen, your baby becomes more visible through your tummy.

However, you might still need to get transvaginal scans if:

• You have a history of preterm labour, and your doctor wants to check your cervix (mouth of uterus and birth canal).
• You are overweight, and an abdominal scan cannot deliver clear images.
• Your doctor suspects you have a low-lying placenta, called placenta praevia.
  

Depending on when in your pregnancy the scan takes place, a TVS can also be used to:

• Check that your pregnancy is progressing normally in the uterus.
• Evaluate the reason for any abdominal pain, vaginal spotting or bleeding.

I'm scared about getting a transvaginal scan. Is it painful?

It's quite natural to feel anxious and vulnerable about getting an internal scan, but rest assured, the TVS isn’t painful.

The probe is long and narrow, and your doctor will gently insert about two or three inches into your vagina. Lubrication will be used to prevent discomfort.

You're likely to feel some pressure as the transducer is inserted and moved about. The more you relax, the easier it will be for your doctor to insert and navigate the probe. If your muscles are tense, the procedure can become uncomfortable.

Try not to worry too much. Throughout the procedure, your doctor will be there to reassure and support you.

However, some women may feel more discomfort than others. Don't hesitate to let your doctor know right away if you feel any pain or uneasiness during the scan.

That said, it's also true that many women prefer a vaginal scan over an abdominal scan, as you don't need a full bladder!

Who does the transvaginal scan in pregnancy?

The pre-conception and pre-natal diagnostic techniques (prohibition of sex selection) Act 1994 (PCPNDT Act) in India allows only a qualified ultrasound doctor registered with the appropriate authority of the district, to perform ultrasounds in a clinic registered under PCPNDT Act.

Both male and female ultrasound doctors do transvaginal scans.

Some women feel embarrassed and awkward about getting a vaginal scan with a male doctor. But remember that the ultrasound doctor does many of these scans every day. Male doctors are also assisted by female nurses who can help with introducing the probe into the vagina.

If you prefer a female doctor, make sure to check in advance and book your appointment accordingly.

How should I prepare for an internal scan?

Check with your doctor about any specific instructions you need to follow before your scan.

Generally, you will need an empty bladder for this scan because a full bladder can get in the way of a clear picture of your baby.

You'll need to undress from the waist down for a TVS. It's a good idea to wear two-piece clothing such as a salwar kameez or a top with comfortable pants, slacks or tights so you won't need to get fully undressed. You'll only need to remove the lowers, and you can continue to wear your top during the scan.

It's a good idea to ask your husband, mother or a close family member to come along to the hospital with you to provide support.

Keep in mind, though, that in some places, family members or attendants may not be allowed to accompany you in the ultrasound room.

What will happen during the transvaginal scan?

When it's time for your appointment, a nurse will ask you to use the restroom before you go in for your scan.

Once you have undressed from the waist down, the nurse will ask you to lie on your back on the examination table or bed.

The nurse will cover your legs with a sheet and ask you to raise your knees while keeping the soles of your feet flat on the bed. A pillow or a booster pad may also be placed under your hips, so they are propped up.

You will need to keep your legs apart so your doctor has enough room to perform the scan. This position is somewhat similar to the one you take when you have an internal examination.

Your doctor will cover the probe with a new, sterile latex sheath that looks like a condom. The latex sheath ensures no germs are transferred into your birth canal. If you are allergic to latex, let your ultrasound doctor and the nurse know so they can use a latex-free sheath instead.

She will apply some gel on the probe to ease its passage into your vagina and to get better clarity of the images. She will then insert about two to three inches of the probe into your vagina and perform the scan.

Try taking deep breaths when the probe is being inserted to help you relax.

Once the probe is in position, sound waves will create images that will be transmitted to a computer. The ultrasound doctor will record specific images and information for your gynae to review.

You may be able to watch the process on the computer screen as your doctor performs the scan. Some doctors have a separate screen for you to see the scan, while others may allow you to take a look.

After the scan is over, your doctor may ask you to wait for some time while the report is being prepared. Or, you may be asked to come back later. If you need the report urgently, let the clinic know in advance.

Are there any risks of getting a transvaginal scan in pregnancy?

When done by an ultrasound doctor or trained health professional, a transvaginal scan will not harm your pregnancy in any way. Ultrasound uses sound waves and not radiation like X-rays.

Some pregnant mums worry that a TVS could cause a miscarriage. But, that's not the case. When done correctly and carried out for a valid reason, a TVS, like any other ultrasound scan in pregnancy, is considered safe.

A transvaginal scan isn’t recommended in some conditions, such as:

• If you have a placenta praevia (low-lying placenta) and experiencing bleeding. A TVS could make the bleeding worse.
• If you have a premature rupture of the membranes, when your waters break early, but you’re not yet in labour. An internal ultrasound at this point may increase the risk of infection.

If you have any questions or concerns, check with your doctor before you go for the ultrasound appointment.

How will I feel after a transvaginal scan?

After your scan, the nurse will give you tissues or wipes to wipe off any residual gel. You wear your clothing and leave.

Most women don’t report any discomfort, but If your muscles were tense during the scan, they feel sore or bruised.

Some women experience slight spotting after the scan. Spotting can happen if some small blood vessels of the cervix get damaged during the scan. This spotting is usually pink or brown in colour and is nothing to worry about.

However, contact your doctor immediately if you have heavy and bright red bleeding along with cramps in your lower abdomen. If you can't reach her, head to the emergency department of the nearest hospital right away.


हिंदी में जानकारी! ट्रांसवेजाइनल स्कैन (टी.वी.एस.)


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