Transvaginal Ultrasound During Pregnancy

A transvaginal ultrasound uses high-frequency sound waves (ultrasounds) to create images of your internal organs as well as a developing fetus. Using a wand-like instrument that's inserted into the vaginal canal, this type of ultrasound provides a clearer view into the uterus, especially early on in pregnancy. Your doctor may order a transvaginal ultrasound for a variety of purposes, including early pregnancy confirmation and due date calculation.

What Is a Transvaginal Ultrasound?

This type of ultrasound is an internal examination and is done transvaginally, which means “through the vagina.” Regular or transabdominal ultrasounds use different, larger "wands" (technically called a transducer) that rest on the top of the abdomen, while a transvaginal procedure is performed by inserting a wand a few inches into the vagina. The transvaginal ultrasound is better able to pick up images in the early stages of pregnancy.

Both types of ultrasounds allow you to view the images on a monitor on the ultrasound machine. Often, transvaginal ultrasound, which is also called endovaginal ultrasound or pelvic ultrasound, provides a better view of the female reproductive organs, including the uterus, ovaries, fallopian tubes, and cervix, because it can get closer to the structures it's examining and the ultrasound waves do not have to travel through the abdomen.

Uses of Transvaginal Ultrasound

This exam is used most frequently before the eighth week of pregnancy. The images from a transvaginal ultrasound are just as good as, if not better than, those created with other types of ultrasounds.

Some doctors prefer to use these tests more frequently than others. Sometimes, your provider may do the procedure themselves during your pregnancy confirmation visit or at a regular prenatal exam, or you may be seen by a separate provider who will conduct the exam. When performed during pregnancy, this type of ultrasound is typically used for the following purposes:

• Assessing the uterine lining
• Assessing the uterus or ovary
• Checking for cysts, particularly in the ovary
• Checking for ectopic pregnancy (tubal pregnancy)
• Checking for possible miscarriage
• Checking the cervix for any changes that could lead to miscarriage or premature delivery
• Confirming early pregnancy by detecting the fetal heartbeat
• Determining the cause of pelvic pain or bleeding
• Estimating the due date more accurately
• Examining the placenta for any abnormalities

How to Prepare

Most of the time, there is nothing you need to do to prepare for a transvaginal ultrasound. In some instances, though, your doctor may provide you with a series of instructions before the appointment, especially if you will need to drink something beforehand.

For example, sometimes a partially full bladder is preferred and other times an empty bladder is needed. If a partially full bladder is needed, you will drink water about 30 minutes before your appointment. Other times, you'll be asked to empty your bladder right before the procedure. 

If you're stressed about the procedure or the potential results of the ultrasound, you may want to engage in relaxation techniques beforehand. Even mindfulness can help to calm your nerves and bring you a sense of peace before, during, and after the procedure. But overall it is a simple and painless procedure and not one that you should worry about.

What to Expect

When getting a transvaginal ultrasound, you may receive this exam while visiting a diagnostics center where a technician performs the ultrasound or your doctor may perform the test in their office. Either way, you will most likely be given a hospital gown to wear, as clothes from the waist down will have to be removed.

During the Procedure

When the doctor or technician is ready to begin, you will lie down on an examination table and place both feet in the stirrups. The ultrasound wand will be covered with a condom and lubricating gel and then inserted into your vagina. This should not be painful, but some women may feel some pressure from the wand. The entire test should last anywhere from 30 to 60 minutes. 

Your Results

If your doctor performs your ultrasound, then you will probably get your results during or immediately following the examination. If a technician does the ultrasound, then the images must first be analyzed by a radiologist before the results are sent to your doctor for review.

Results typically take 24 hours to come in. Your doctor will then talk to you about your results and any recommended course of treatment or action, depending on what is found in the ultrasound images. In some cases, you may have to go back for another appointment to repeat the procedure if a clear picture wasn't obtained.

A Word From Verywell

Although it is a bit invasive, a transvaginal ultrasound is not painful and poses no risk to you or your baby. Additionally, this test can provide key diagnostic information early in pregnancy—as well as the first photos of your little one. If you have questions or concerns about the procedure, don't hesitate to ask your doctor.