“Clinical Applications of the Transvaginal Ultrasound Exam for Obstetric-Gynecologic Emergencies”

This review describes the utility of transvaginal ultrasound (TVS) for emergent obstetric-gynecologic (OB-GYN) conditions. It additionally compares this component of the ultrasound exam to transabdominal ultrasound (TAS) and considers barriers to the universal use of TVS in evaluating OB-GYN emergencies in the emergency department (ED). TVS has been found to be both more sensitive and specific than TAS in diagnosing ectopic pregnancy in the acute care setting. The use of TVS has been shown to be effective in diagnosing placenta accreta spectrum, placenta previa, and low-lying placenta, and is valuable in the diagnosis of ovarian torsion, ruptured ovarian cysts, and tubo-ovarian abscess. TVS is a sensitive and specific tool for diagnosing many obstetric and gynecologic emergencies. This technique should be implemented widely to help address the rising maternal mortality rate in the United States.