When you come for an ultrasound scan, you will be issued with a medical ultrasound report. Whether you are seen here in our lovely private service at Somerset Early Scans, or in the NHS, a report will always be issued. So what is the report for and what do the words in it mean?
Why is a report issued?
The written report is a document that describes what the sonographer, nurse or doctor saw when they scanned you. It is issued to provide a record of the findings, in order to help medical professionals in advising you on your optimum subsequent care.
In pregnancy it is most important that the dates and measurements are recorded, with certain specific findings being reported on, depending on how many weeks pregnant you are.
For a gynaecology scan, the report focuses more on descriptive terminology. Some measurements are also performed. Again certain important standardised points will always be reported on.
Medical words are used, in order to help the medical team quickly and easily understand and interpret the findings.
What do the medical words mean?
Non pregnant terminology
- Type of scan performed: the report will say “transabdominal” (tummy scan) or “transvaginal” (internal scan)
- Quality of views: if the views were not very clear, any reason for this will be listed, such as weight/body mass index, or an inadequetely filled bladder.
- Orientation of the womb: “the uterus is anteverted” means it tilts forward, which is normal and seen in 85% of women. “the uterus is retroverted” means it tilts backwards and is also usually normal, and seen in 15%. If the uterus is “axial” (which is less common but also normal), this means it lies at such an angle that makes ultrasound views very unclear.
- Appearance of the womb: this would be commented on, whether it appears normal in it’s shape, as sometimes there can be hereditary or acquired variations. Also it’s “echotexture” which describes its grayscale colour. This can be “homogenous” i.e. uniform, or “heterogenous” i.e. variable as you might see most commonly with fibroids.
- Size of the womb: this would be measured in a non pregnant scan and can vary depending on stage of the menstrual cycle and how many babies you have had. It is normally around 6-9cm / 60-90mm in length.
- Womb lining: this is called the “endometrium” and is the inner lining of the womb that grows and sheds each month. If you are pre-menopausal it will be reported as being “trilaminar” i.e. 3 layer in appearance when it is growing in the first half of the cycle. At other times descriptors like “smooth, uniform, or homogenous (all the same colour) will be used. If a pregnancy sac is not present, it’s thickness is measured.
- Follicle: these are little dark areas on the ovaries where eggs grow. In a fertility context, we would count the number we see in each ovary and this is called the “antral follicle count”.
- Ovarian cyst: before the menopause the ovaries are rapidly changing, cycling structures and little fluid filled sacs (cysts) come and go due to preparing for ovulation (releasing an egg) each month. Sometimes this leaves a little sac on the ovary that sometimes bleeds (haemorrhagic cyst) and almost always resolves with time. We would call it a cyst if it is above 3cm.
- Obscured by bowel: this means we couldn’t see an ovary as the bowel was overlying it and casting acoustic shadows. This is very common and normal.
Pregnant terminology
- Gestation sac: this is an early pregnancy term referring to the pregnancy sac. If we don’t yet see the baby as it’s too early, this would be measured in 3 dimensions and a mean figure reported (“mean gestation sac diameter”)
- Position of the gestation sac may sometimes be described; it is usually “eccentric” i.e. not quite in the centre
- Yolk sac: this is the first embryological part of the baby that we see when scanning very early in pregnancy. It looks like a circle. It helps show that the pregnancy is in the right place (not “ectopic”)
- Crown Rump Length/ CRL: this is the measurement from top to bottom of the baby from which we generate a due date
- Adnexa: this means the area next to the womb on either side, where the fallopian tubes and ovaries are. We check this to look for any ovarian cysts or other rare findings.
- Corpus luteum: this is a little area on the ovary where you ovulated (released an egg) from. It releases hormones to maintain the pregnancy before the placenta takes over.
- Nuchal translucency: this is the thickness of the skinfold at the back of the baby’s neck, which is measured at your NHS dating scan as part of screening for Down’s syndrome and other conditions.
- Lambda sign: a dividing strip between two gestation sacs that shows there are twins!
- Head circumference: this is the measurement around the baby’s head and is used later in pregnancy to date the pregancy if the baby is too big to do a CRL, and also to check the baby’s growth.
- Abdominal circumference: this is the measurement around the baby’s tummy which is used to check growth in the third trimester.
How will I get my report?
At Somerset Early Scans this will be given to you as a printed A4 report, or shared with you electronically via our secure cloud based notes software. It does not automatically go to your GP or midwife, so please share the report with them if they need it.
If we need to refer you to another clinician we will seek your consent to share the report securely with that service. In an emergency, we would also give a verbal handover of information to the admitting medical team.
Your clinician will run through the report with you to explain any terminology. If you have any questions, please ask! We have designed our service to be a premium experience, with 30 minute appointments so there is time to answer all your questions and make sure you leave well informed.
Conclusion
I hope this blog has helped to explain the medical terminology you will most commonly see in your pregnancy, fertility or gynaecology ultrasound report. Medical language is so complex. It does definitely save time when communicating with colleagues. However, I do wonder whether historically Doctors came up with it partly as a way to make them sound clever! Today’s generation of clinicians recognise the importance of making information accessible to it’s owners, the patients.
Dr Joanna Clark