Gynecologic ultrasound and obstetric ultrasound are two distinct applications of ultrasound imaging that serve different purposes in the field of women's health. While both involve the use of ultrasound technology to examine the pelvic region, they have different focuses and objectives.

Gynecologic [gynaecologic, Brit.] ultrasound primarily concentrates on the evaluation of the female reproductive organs, including the uterus, ovaries, fallopian tubes, and surrounding structures. It is commonly performed for various gynecological concerns, such as abnormal bleeding, pelvic pain, infertility investigations, and monitoring of reproductive disorders. It can identify signs of inflammation, the presence of free fluid, cysts, and tumors. This non-invasive technique aids in diagnosing and monitoring gynecological pathologies, facilitating early intervention and appropriate treatment. Typically, a transabdominal sonogram is performed with a full bladder to provide an initial assessment. However, if the pelvic ultrasound reveals any abnormalities or fails to provide a clear image of the organs, a more detailed evaluation can be achieved through a transvaginal sonography. This approach allows for improved visualization of the uterus and ovaries by placing the ultrasound probe inside the vagina.

Obstetric ultrasound, also known as prenatal, fetal or pregnancy ultrasound, is the branch of medical imaging that focuses on the use of ultrasound technology to assess the health and development of a fetus during pregnancy. Women with uncomplicated pregnancies commonly undergo an ultrasound examination between the 16th and 20th week of gestation. This routine assessment, performed with a real-time scanner, serves to determine accurate gestational age, monitor fetal size, and assess overall growth. The middle of the pregnancy trimester provides a crucial window for detecting many abnormalities of fetal anatomy. Advanced imaging techniques enable healthcare professionals to identify potential structural issues. Early detection of these abnormalities allows for timely intervention, counseling, and the implementation of appropriate management strategies.
See also Pregnancy Ultrasound, Pelvic Ultrasound, Hysterosalpingo Contrast Sonography and Vaginal Probe.

The earliest introduction of vascular ultrasound contrast agents (USCA) was by Gramiak and Shah in 1968, when they injected agitated saline into the ascending aorta and cardiac chambers during echocardiographic to opacify the left heart chamber. Strong echoes were produced within the heart, due to the acoustic mismatch between free air microbubbles in the saline and the surrounding blood.

Interventional ultrasound, also known as ultrasonography, encompasses a range of invasive or surgical procedures guided by ultrasound imaging. While its widest application lies in intravascular ultrasound imaging for measuring atherosclerotic plaque, it has proven valuable in various medical fields.
In urology, ultrasound-guided interventions are employed for treatments like high intensity focused ultrasound (HIFU) in prostate conditions. The precise imaging provided by ultrasound aids in targeting the affected area and delivering therapeutic energy effectively.
In intraabdominal conditions, endoscopic ultrasound is frequently utilized. This technique combines ultrasound imaging with an endoscope to visualize and evaluate structures within the gastrointestinal tract, allowing for precise diagnoses and targeted interventions.
Ultrasound-guided procedures play a significant role in several medical specialties, including liver sonography, obstetric and gynecologic ultrasound, and thyroid ultrasound. These procedures involve interventions such as RF thermal ablation or biopsies, which are guided by real-time ultrasound imaging.
For instance, in liver sonography, ultrasound guidance is crucial for performing biopsies or RF thermal ablation, a technique used to treat liver tumors by delivering localized heat to destroy the abnormal tissue. The real-time imaging allows for precise needle placement and monitoring during the procedure.
In obstetric and gynecologic ultrasound, ultrasound-guided procedures, such as biopsies, can be performed to obtain tissue samples for diagnostic purposes. Additionally, ultrasound guidance is valuable during interventions like amniocentesis or fetal blood sampling, enabling accurate and safe procedures.
Thyroid ultrasound procedures often involve ultrasound-guided fine-needle aspiration biopsy (FNAB), which allows for the sampling of thyroid nodules for cytological examination. The ultrasound image helps guide the needle into the targeted area, ensuring accurate sampling and minimizing potential complications.
Overall, ultrasound-guided interventions provide minimally invasive and precise approaches to diagnosis and treatment. The real-time imaging capabilities of ultrasound contribute to enhanced accuracy, safety, and patient outcomes in procedures like biopsies, injections, and drainage.

See also Transurethral Sonography, Endocavitary Echography, and B-Mode Acquisition and Targeting.

2D ultrasound imaging is a widely used technique in medical imaging that provides two-dimensional visual representations of internal structures. A handheld device known as a probe or transducer contains piezoelectric crystals that emit and receive ultrasound waves which penetrate tissues and bounce back as echoes. The echoes are detected and converted into electrical signals. These signals are processed and displayed on a monitor, creating a real-time 2D grayscale image, with different shades of gray representing various tissue densities. The brighter areas on the image correspond to structures that reflect more ultrasound waves, while darker areas represent structures that reflect fewer waves or are attenuated by intervening tissues. The 2D-mode (or B-mode) provides cross-sectional views of the scanned area, showing a single plane or slice of the scanned area at a time.

Key Features and Uses of 2D Ultrasound:

Comparison with 3D and 4D Ultrasound:
See also Ultrasound Technology, Sonographer, Ultrasound Elastography, Obstetric and Gynecologic Ultrasound.

As far as ultrasound is concerned, 4D ultrasound (also referred to as live 3D ultrasound or 4B-mode) is the latest ultrasound technology - the fourth dimension means length, width, and depth over time. 4D Ultrasound takes 3D ultrasound images and adds the element of time to the progress so that a moving three-dimensional image is seen on the monitor. A 4D scan takes the same amounts of time as a 2D or 3D scan; the difference is the ultrasound equipment being used. One advantage of a 4D fetal ultrasound to a 2D-mode is that parents can see how their baby will generally look like. However, there are different opinions over the medical advantages.
To scan a 3D ultrasound image, the probe is swept over the maternal abdomen. A computer takes multiple images and renders the 3D picture. With 4D imaging, the computer takes the images as multiple pictures while the probe is hold still and a 3D image is simultaneously rendered in real time on a monitor.
In most cases, the standard 2D ultrasound is taken, and then the 3D/4D scan capability is added if an abnormality is detected or suspected. The 3D/4D sonogram is then focused on a specific area, to provide the details needed to assess and diagnose a suspected problem. A quick 4D scan of the face of the fetus may be performed at the end of a routine exam, providing the parents with a photo.
See also Obstetric and Gynecologic Ultrasound, Pregnancy Ultrasound, Fetal Ultrasound and Abdominal Ultrasound.