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.

Submicron ultrasound contrast agents are gas-filled, double-walled microspheres with a diameter smaller than 1 μm that rupture when exposed to ultrasound energy at megahertz frequencies. These agents differ from traditional ultrasound contrast microbubbles in that the submicron bubbles may serve as extravascular agents. They are small enough to travel through the lymphatic system and to be extravasated from tumor neovasculature. The detection of these agents is limited by their hard shell, which requires high-pressure ultrasound insonation for shell rupture and excitation of the gas bubble. After shell rupture, the gas diffuses rapidly from submicron sized agents. The optimal processing of each echo is important.

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.
The disadvantage of this microbubbles produced by agitation, was that the air quickly leak from the thin bubble shell into the blood, where it dissolved. In addition, the small bubbles that were capable of traversing the capillary bed did not survive long enough for imaging because the air quickly dissipated into the blood. Aside from agitated saline, also hydrogen peroxide, indocyanine green dye, and iodinated contrast has been tested. The commercial development of contrast agents began in the 1980s with greatest effort to the stabilization of small microbubbles.

The development generations by now:
To pass through the lung capillaries and enter into the systemic circulation, microspheres should be less than 10 μm in diameter. Air bubbles in that size range persist in solution for only a short time; too short for systemic vascular use.
The first developed agent was Echovist (1982), which enabled the enhancement of the right heart. The second generation of echogenic agents, sonicated 5% human albumin-containing air bubbles (Albunex), were capable of transpulmonary passage but often failed to produce adequate imaging of the left heart. Both Albunex and Levovist utilize air as the gas component of the microbubble.
In the 1990s newer developed agents with fluorocarbon gases and albumin, surfactant, lipid, or polymer shells have an increased persistence of the microspheres. This smaller, more stable microbubble agents, and improvements in ultrasound technology, have resulted in a wider range of application including myocardial perfusion.

See also First Generation USCA, Second Generation USCA, and Third Generation USCA.

Tissue-specific ultrasound contrast agents improve the image contrast resolution through differential uptake. The concentration of microbubble contrast agents within the vasculature, reticulo-endothelial, or lymphatic systems produces an effective passive targeting of these areas. Other contrast media concepts include targeted drug delivery via contrast microbubbles.
Tissue-specific ultrasound contrast agents are injected intravenously and taken up by specific tissues or they adhere to specific targets such as venous thrombosis. These effects may require minutes to several hours to reach maximum effectiveness. By enhancing the acoustic differences between normal and diseased tissues, these tissue-specific agents improve the detectability of abnormalities.
Some microbubbles accumulate in normal hepatic tissue; some are phagocytosed by Kupffer cells in the reticuloendothelial system and others may stay in the sinusoids. Liver tumors without normal Kupffer cells can be identified by the lack of the typical mosaic color pattern of the induced acoustic emission. The hepatic parenchymal phase, which may last from less than an hour to several days, depending on the specific contrast medium used, may be imaged by bubble-specific modes such as stimulated acoustic emission (color Doppler using high MI) or pulse inversion imaging.

(MRgFUS) Magnetic resonance guided focused ultrasound is a surgical procedure that uses high intensity focused ultrasound waves to destroy tissue in combination with magnetic resonance imaging (MRI), which guides the treatment.
With focused ultrasound waves uterine fibroids are heated and destroyed (ablated) inside the MRI device , allowing the physician to plan, monitor and control the treatment with temperature sensitive images while it is in progress.

See also High Intensity Focused Ultrasound, and Interventional Ultrasound.