Many patients and physicians in the community are aware of the obstetric ultrasound services available at Cannon Place, through the Prenatal Wellness Center.  In addition to state of the art obstetric ultrasound services, Cannon Place clinic offers advanced pelvic ultrasounds to diagnose common problems in gynecology.  At Cannon Place, we use state of the art ultrasound techniques including abdominal ultrasound, vaginal ultrasound and Saline Infused Ultrasound. 

Irregular Bleeding
Irregular bleeding is a common, bothersome problem in gynecology.  Hormonal imbalances are a common reason for abnormal menstrual cycles, and this usually responds to simple medical treatments such as low dose birth control pills or other hormonal manipulations.  However, abnormal bleeding can also be caused by a build up of the lining of the uterus or benign growths, such as fibroids or polyps, inside the uterus. 

Using abdominal and vaginal ultrasound, we can determine if the lining of the uterus is thickened.  This is particularly helpful in examining a woman who is post menopausal and is having irregular vaginal bleeding.  Saline infused ultrasound involves putting a small amount of sterile water in the uterus during a vaginal ultrasound, to open up the uterus and be able to see structures inside the uterus, such as polyps or fibroids, which can cause irregular bleeding. 

Fibroids
Up to 65% of all American women have uterine fibroids.  These are benign, meaning not cancerous, muscle tumors of the uterus.  They are more common in African American women.  If your sister or mother had fibroids, you are at a higher chance of having fibroids.  Many women with fibroids do not have any symptoms and do not need treatment.  However, fibroids can cause heavy menstrual periods, leading to a low blood count (anemia) and fatigue.  Fibroids may also grow and cause pelvic pressure, fullness, and pain.  Some fibroids may be as large as an early pregnancy, pushing on the bladder or rectum.  Abdominal or vaginal ultrasound can be used to determine the size and location of fibroids.  Saline infused ultrasound can be used to see if the fibroids are inside the uterine cavity, which can cause bleeding.  Ultrasound can help your physician determine the best treatment for your fibroids.  These treatments may involve merely taking iron supplements, to build up your blood count.  Other treatments include removing the fibroids through your cervix or abdomen, or removing the uterus through the vagina or abdomen.

Early pregnancy problems
Approximately 25% of women will have light bleeding (spotting) in early pregnancy.  Vaginal ultrasound can diagnose a pregnancy as early as 1 – 2 weeks after a missed menstrual period.  The fetal heart beat is present at this time.  If you are having bleeding and are early in your pregnancy, ultrasound should be done to determine if the bleeding is a normal consequence of the placenta growing in the uterus, or if an abnormal pregnancy exists.  Abnormal pregnancies located in the uterus are called miscarriages or blighted ovums.  Abnormal pregnancies located in the fallopian tubes are very serious and possibly life threatening, and are called ectopic pregnancies.  Vaginal ultrasound can be used in early pregnancy to make sure the pregnancy is properly located in the uterus, and that a fetal heart beat is present and normal.  Vaginal ultrasound can also be used to diagnose twins or triplets early, particularly in women who have had fertility treatments.  By determining if twins or triplets are present early, we can refer a patient to our high risk obstetric clinic.

Ovarian Cysts or Ovarian Masses
Ovarian cysts or masses can be caused by many conditions.  Most causes of ovarian cysts are benign or not cancerous.  Some ovarian cysts are cancerous.  The best way to exam the ovaries is through a pelvic exam, but ultrasound can assist your doctor in determining if an ovarian mass felt on exam appears cancerous or non-cancerous.  Ultrasound can be used to determine the right treatment for an ovarian cyst.  These treatments include waiting and reexamining the cyst again or looking at the ovaries through a camera placed in the pelvis, or removing the ovarian cyst through an abdominal incision. Ovarian torsion is a rare cause of severe pelvic pain where the ovary gets twisted and the blood supply to the ovary gets cut off.  By using ultrasound to exam the blood flow to the ovaries, ultrasound can also help diagnose twisting or torsion of the ovary.  Torsion of the ovary is treated by emergent surgery. 

Expert Consultation
Because the pelvic ultrasounds are performed at Cannon Place, where several gynecologists work, patients have access to a gynecologist to follow up with in the event that an abnormality is found on an ultrasound.  If necessary, your family doctor or internist can refer you for a pelvic ultrasound at Cannon Place, and if you need to see a gynecologist, we can arrange this appointment for you.  We will also let your family doctor or internist know about the findings during your pelvic ultrasound.  Drs. Donald Fylstra and Margaret Villers can be contacted regarding pelvic ultrasounds at Cannon Place.  Please call 843-792-5300 for an appointment.