Transvaginal ultrasound scan (TVS) in early pregnancy

Who is the leaflet for? What is its aim?

As you have been having some concerns early in your pregnancy it has been recommended that you have an ultrasound scan. The best method of scanning at this early stage is a transvaginal ultrasound scan, this leaflet explains what this involves and the risks and benefits of the procedure.

What is a transvaginal ultrasound scan?

This is an internal scan and is less uncomfortable than a smear test; generally the scan is well tolerated. It takes about 10 minutes to perform.

Before the scan

Before the scan you need to empty your bladder. The sonographer or doctor will ask you some questions and then ask you to remove the clothing below your waist in a private space, and you will be provided with a modesty sheet to cover yourself.

It is mandatory within the Trust that a formal chaperone is present for all intimate examinations. If you would like more information on this, please speak to a member of staff.

The sonographer or doctor may be identifying as male/female/non-binary, if this is a concern for you please talk to one of the nursing staff as soon as possible.

You are welcome to bring another person with you to your scan for support and this is something that we encourage. However due to the limited space in the scan room, we request that only one other person attend with you. We respectfully ask that no persons under the age of 18 attend the clinic.

Unfortunately, we sometimes have to give bad news. For this reason, the person carrying out the ultrasound will take their time to be sure before informing you of the results. Many women may opt not to view the images and many find it helpful to see the images. For this reason, this discussion may take place before the ultrasound examination is complete to give you the choice of what you wish to do.

During the scan

When you are settled on the couch, the sonographer or doctor will gently insert the tip of a round edge probe into the vagina. This probe is cleaned and disinfected between each patient and covered with a new probe cover, which is latex free. Water based gel is also used to prevent friction.

An image of your pelvic organs is seen on the monitor and the findings will be discussed with you and documented in a report. Vaginal bleeding does not affect the scan.

Trainees

This is a teaching hospital and the department does train sonographers/doctors in transvaginal scanning. If you would rather not have a trainee in the room at the time of your scan please let us know.

Benefits

• An internal scan enables the sonographer or doctor to obtain a clear image of your pelvic organs (womb, ovaries and bladder).
• Transvaginal ultrasound is the preferred best practice for early pregnancy scanning. There is no increased risk of miscarriage.
• In early pregnancy, a transvaginal ultrasound can give more detailed images compared to an abdominal approach which may give us a better understanding of your pregnancy.

Risks

• There are no risks to the safety of your pregnancy from having a TVS.
• All probe covers are latex free, so there is no risk of an allergic reaction.

Alternatives

If you do not wish to have a transvaginal scan you can discuss the option of a scan via the abdomen. In these cases a full bladder is necessary and you will need to drink approximately 500-1000mls of water an hour before your appointment time.

It is not always possible to obtain the same amount of information using an abdominal scan and therefore we may not be able to establish what exactly is happening with your pregnancy. Therefore you may require a further scan at a later date.

Contacts/Further information

Clinic 24 (early pregnancy unit and emergency gynaecology unit)

01223 217636

Monday to Friday 08.00 – 20.00

Weekends 08.30 –14.00 Closed bank holidays

Daphne ward (inpatient gynaecology ward)

01223 257206

At all times

References / Sources of evidence

National Institute of Clinical Excellence (NICE). 2019. Clinical Guideline 154: Ectopic pregnancy and miscarriage: Diagnosis and initial management in early pregnancy London (opens in a new tab)

Royal College of Obstetricians and Gynaecologists (RCOG). 2016, Information for you: Bleeding and/or pain in early pregnancy. London. (opens in a new tab)

Chaperones: Requirement for use of chaperones. Cambridge University Hospitals NHS Foundation Trust (2020)

Privacy and dignity

We aim to ensure that privacy and dignity are maintained at all times. There are private changing areas and toilet facilities within the Clinic.