Journal of Ultrasound in Medicine, Vol 20, Issue 8 869-875, Copyright © 2001 by American Institute of Ultrasound in Medicine
Sonographic diagnosis of pelvic adhesions in patients after ovum pickup
J. Shalev, R. Mashiach, B. Fisch, M. Royburt, I. Bar-Hava, H. Krissi and I. Meizner
Ultrasound Unit, Department of Obstetrics and Gynecology, Rabin Medical Center, Petah Tikva, Israel.
OBJECTIVE: To evaluate the use of transvaginal sonography for the detection
of pelvic adhesions by using clear free fluid in the pouch of Douglas found
after ovum pickup. METHODS: A prospective clinical study was performed in
an infertility unit of an academic research facility. Sonography was
performed in 50 women with infertility 3 days after ovum pickup, and the
visceral peritoneum of the uterus, the ovaries, and the fallopian tubes was
scanned for possible pelvic adhesions. RESULTS: The serosal surfaces of the
uterus, ovaries, and fallopian tubes were successfully observed for the
presence of adhesions in 86%, 68%, and 20% of the patients, respectively.
Improved visualization was associated with an increased amount of pelvic
fluid for the uterus (P = .01) but not for the ovaries and fallopian tubes.
The amount of fluid in the pelvis correlated with an increased number of
retrieved oocytes (P = .07) and a decreased need for manual manipulation to
achieve proper imaging of the uterus (P = .001). CONCLUSION: Transvaginal
sonography performed in the presence of fluid in the pelvis may show
adhesions mainly attached to the uterus and ovaries. Assessment of possible
mechanical factors is important in planning treatment of patients with
infertility.
