More Obstetric and Gynaecology Resources:
These are common questions on Gynaecology and Pregnancy Ultrasounds at QDOS. You will also find some practical information for your appointment.
Please allow ONE HOUR for your visit. Ultrasound examinations vary in length and unexpected findings arise which may prolong your or a preceding examination. We can not promise you an exact time frame. You are welcome to ring ahead to check if we are running on time, which is always our aim, before you start to drink the required amount of water.
We only perform ultrasounds requested by a doctor for medical reasons. A separate referral is required for each booking and should be brought with you on the day (unless you have already emailed it to our admin team). The referral is needed to answer the clinical questions correctly, and is a Medicare requirement for you to receive a rebate. Please also bring any reports or pictures you have from ultrasounds performed at other practices, as change over time helps interpret your current ultrasound. If you do not have the report or pictures, find out the name of the practice where you had the ultrasound, so we can contact them.
There are free parking bays for 3 small cars behind the clinic, accessed from Stent Lane (behind the staff cars). If you drive a larger car, you may have difficulty using these spaces. All street parking in the area is metered and unfortunately available spaces can be difficult to find. Please consider allowing extra time before your appointment to find parking. For those who prefer public transport, QDOS can be reached via buses travelling along Cambridge Street, or from Subiaco Train Station (walking via St John of God Subiaco Hospital).
Payment is due on the day of the scan. It can be cash, cheque, EFTPOS or credit card (Visa, MasterCard or Amex). The fees vary depending on the type of ultrasound and stage of pregnancy. Age pensioners will be charged a reduced fee if a valid personal Commonwealth pension card is shown on the day of the ultrasound. Our Ultrasound costs are available for your information.
Having fluid in the bladder helps lift the pelvic organs into view and gently moves the bowel out of the way, which improves the clarity of the images.
Please follow the guidelines below before your appointment:
Early pregnancy scans (up to ~12 weeks):
Drink 1 glass of fluid about 1 hour before your appointment.
Gynaecology scans and pregnancy scans up to 18–20 weeks:
Drink 2 glasses of fluid about 1 hour before your appointment.
Gynaecology scans where a vaginal (internal) scan is not suitable or not wanted:
Drink 3 large glasses of fluid about 1 hour before your appointment.
Adolescents and young patients:
A very full bladder is required, as this gives the clearest images.
➤ Aim to drink around 1 litre of fluid about 1 hour before your scan.
Late pregnancy (beyond 22 weeks):
A full bladder is often less comfortable and not always necessary, but 1 glass of fluid can help us obtain the correct angles and measurements.
The ultrasound findings are explained to you after, or sometimes during, the scan, and you will have an opportunity for questions. Interpretation of gynaecology ultrasound often needs a clinical context, which the referring doctor will understand best, or occasionally other tests may be required, so you may not always feel you have been given the “full picture” on the day. For pregnancy scans you will know if the baby appears healthy or whether there are concerns, and the results of screening tests are given to you on the day if all components of the test are ready.
Most reports are completed and sent out to your doctor within 24 hours of the scan being performed, often on the same day. However, delays in completion can occur due to unexpected workloads or the need to review prior ultrasound findings or other clinical information as part of the interpretation.
Pregnancy ultrasound bookings can be on the same day as your appointment with your doctor where the timing works out well for both. Reports on gynaecology ultrasounds often take longer, so unless there is a special reason for the appointment being the same day (eg. you are travelling a long way) it is preferable to allow at least one day for the report to be ready. It is a good idea to let us know if you plan to see your doctor within a day or two of your scan, so we can ensure the report will be there in time. Your referring doctor will receive the report electronically or by fax, depending on their preference. We will also upload the report to your digital My Health Record, if you consent to us doing so.
Pregnancy ultrasound is mainly performed transabdominally, as there is more control over the views, and it is less invasive of your privacy. For specific reasons a transvaginal ultrasound may also be required. This comes up most often in very early stages of pregnancy such as finding a heartbeat, but occasionally arises at any stage, such as the length of the cervix or the lower edge of the placenta. In circumstances where this information will be more precise by the vaginal approach, the reason/benefit will be explained.
When deciding who you will bring, consider the following:
The more people present, the more distractions there are, both for you and for us. For more than 3 people, we suggest you share your downloaded images later.
We don’t mind children coming along to your scan. Young children often need to come for family reasons but are rarely interested in the picture, so please bring an adult to help with them if you can. Though we understand it can be very effective, please do not use food to keep young children entertained in the scan room. Drinks are fine.
We can usually get some favourable 3D/4D views at your 12-14 and 18-20 week ultrasounds, but the medical assessment is performed mainly in 2D (real-time) ultrasound, since that is the image that shows us through the developing baby to see their internal organs. If 3D/4D is obtainable at later stages of pregnancy, the pictures can be impressive, but at the time most late referrals are made for medical reasons, the size of the baby and changes in fluid can make it difficult for clear 3D pictures. See our section on 3D – 4D Ultrasound
Down syndrome (also called Trisomy 21) results from presence of a third copy of genetic information from the Chromosome 21 in the cells of the body. It occurs in about 1 in every 400 pregnancies and results in changes in the physical features, growth and development of a baby. If you have been offered tests for Down syndrome but feel you need to know more about the condition, we suggest you visit the Down Syndrome Australia website via this link https://www.downsyndrome.org.au/. Information about the screening tests is under the 12-14 week Scan*** and about diagnostic tests is under CVS and Amniocentesis. For a more detailed decision-making tool, see the Your choice – Murdoch Children’s Research Institute and Down Syndrome Australia – We are the voice of Down syndrome
A few days makes a big difference to what you and we can see at this stage of pregnancy, and you will feel more satisfied with your scan if you keep to the recommended timing, which is 12 to 12 ½ weeks for cFTS (Down syndrome screening) or 13 to 14 weeks if you have already had NIPT. This way, some early anatomy checks may be achieved, and if the dates are different to those predicted from your period, screening can usually still be performed if desired. If there is a good reason to alter the timing, such as bleeding or an increased risk of problems, this can certainly be taken into account.
The 18-20 week ultrasound is intended to check the baby (fetus) thoroughly, with time for further evaluation (by ultrasounds, amniocentesis or advice from other specialist doctors) and discussion if problems are found. The timing usually can be flexible if there is a good reason, such as if you or your partner work fly-in fly-out. If you have a larger body or significant abdominal wall scarring, then it may be preferable to have the ultrasound slightly later so that the fetus is a little larger and easier to image.
The sex of the baby can be determined accurately most of the time at the 18-20 week scan, and estimated with ~70% accuracy at many 12-14 week scans. We are happy to tell you what we see, or keep it a secret for you – whatever you prefer. We can also put the answer in a sealed envelope for you to open when ready. If you want to keep the sex a secret, we will ask you to look away from the screen occasionally during your scan but please be aware that sudden fetal movements can mean that the genitals may become visible unexpectedly.
A few instantaneous thermal prints are given to the parents for pregnancy ultrasounds. For the main pregnancy scans (12-14 week and 19 week ultrasounds) we provide an individual link for parents to download some images of the baby. The pictures you download are then available to share with your own family and friends. However as the best information is seen in real-time live scanning, the report (rather than the accompanying pictures) provides the most detailed result for your Doctor to view.
For gynaecological ultrasound, a vaginal ultrasound adds extra important detail to almost all scans, but abdominal ultrasound is still a good overview, so we expect to use both. However we understand that vaginal ultrasound is not appropriate for everyone, and no one is required to have any ultrasound that they do not want. Vaginal ultrasound is typically an easier examination than a cervical examination (using a ‘duck-billed’ speculum). If you do not think you will want vaginal ultrasound performed, the bladder filling becomes more important.
There is no requirement to fast for any of our scans. The deep endometriosis assessment recommends use of laxatives the night before to help empty your bowels, but it is still okay to eat meals on the day as usual.
This doesn’t really matter, though some outfits are less convenient than others (we’re looking at you, overalls, playsuits and body-suits!). For vaginal scans you will need to undress from the waist down, though a loose skirt or dress can simply be lifted, making them convenient, warm-weather choices.
You are welcome to bring a family member or friend as a support person. If you expect to agree to an internal (vaginal) ultrasound, make sure that your chosen support person is someone you will be comfortable to have in the room with you. Alternatively, they can go out to our wait-room and come back in for discussion of results, if you desire.
We understand that sometimes young children need to come for family reasons. Ideally you should bring an adult to help with them if you can. Be aware that small children may find it difficult to curb their curiosity about what is happening under the cover sheet during an internal scan. If capable of toddling, they have been known to come and take a close look! Though we understand it can be very effective, please do not use food to keep young children entertained in the scan room. Drinks are fine.
There is no doubt that ovarian cancer is serious enough to offer tests. The problem is that the available tests are not reliable for screening the population at risk. Put simply, they detect too much non-cancerous changes whilst not detecting enough early cancer.
The forms of screening which are currently available are (1) a blood test and (2) ultrasound. The blood test is readily available but only half of women with early cancer (the best stage to catch it for a chance of a cure) have an abnormal blood test result. Even when the blood test comes back abnormal, it is not usually due to cancer, but a lot of anxiety is experienced whilst waiting for further tests and results. Ultrasound can show ovarian cancer, but is only really useful for screening if the cancer is detected while confined to an ovary. Extensive research has shown that some ovarian cancers can spread before the disease is visible with ultrasound or at surgery. Also, when ultrasound shows something worrying, this may require an operation to rule out a cancer. The research shows that each case of saving a woman’s life from cancer has not justified the number of operations (with their own risks and inconvenience) that are required in healthy women who turn out not to have cancer.
A lot of work is being done around the world to search for an effective screening test. In the meantime, screening for ovarian cancer is not recommended for those with no family history. If you want screening, in spite of the lack of proof of effectiveness, you should discuss the advantages and disadvantages of the blood test, ultrasound or both with your Doctor. If you have both, the blood test should be ahead of the ultrasound so that we are aware of any raised result. However, it is important to understand that the best a normal ultrasound can be said to provide, is reassurance of a lower incidence of ovarian cancer within a year.
Websites we think you may find useful for more pregnancy and gynaecology information.
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QDOS Ultrasound provides specialist obstetric and gynaecology ultrasound performed by highly experienced and motivated doctors and sonographers. The rooms are purpose-built, located on the ground floor at 12 Connolly Street, West Leederville, at the rear of Connolly House, which is on the corner of Connolly and Cambridge Streets, opposite SJOG Hospital Subiaco.
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PERTH – Western Australia 6007
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