AIUM Practice Parameter for the Performance of Ultrasound of the Female Pelvis, 2024 Revision

Abstract

The American Institute of Ultrasound in Medicine (AIUM) is a multidisciplinary association dedicated to advancing the safe and effective use of ultrasound in medicine through professional and public education, research, development of clinical practice parameters, and accreditation of practices performing ultrasound examinations.

The AIUM Practice Parameter for the Performance of Ultrasound of the Female Pelvis was developed and revised by the American Institute of Ultrasound in Medicine (AIUM) in collaboration with other organizations whose members use ultrasound for performing these examinations (see “Acknowledgments”). Recommendations for personnel requirements, the request for the examination, documentation, quality assurance, and safety may vary among the organizations and may be addressed by each separately.

This Practice Parameter is intended to provide the medical ultrasound community with recommendations for the performance and recording of high-quality ultrasound examinations. The parameter reflects what the AIUM considers the appropriate criteria for this type of ultrasound examination but is not intended to establish a legal standard of care. Examinations performed in this specialty area are expected to follow the Parameter with the recognition that deviations may occur depending on the clinical situation.

Physicians interpreting or performing this type of ultrasound examination should meet the specified AIUM Training Guidelines¹ in accordance with AIUM accreditation policies.²

Sonographers performing the ultrasound examination should be appropriately credentialed³ in the specialty area in accordance with AIUM accreditation policies.²

Physicians not personally performing the examination must provide supervision, as defined by the Centers for Medicare and Medicaid Services Code of Federal Regulations 42 CFR §410.32,⁴ which is available from the U.S. Government Publishing Office.

The written or electronic request for an ultrasound examination must originate from a physician or other appropriately licensed health care provider or under the provider's direction. The clinical information provided should allow for the performance and interpretation of the appropriate ultrasound examination and should be consistent with relevant legal and local health care facility requirements.

The following section details the examination to be performed for each organ and anatomic region in the female pelvis. All relevant structures should be identified by the transabdominal and/or transvaginal approach. A transrectal or transperineal approach may be useful in patients who are not candidates for introduction of a vaginal transducer and in assessing the patient with pelvic organ prolapse. More than one approach may be necessary.^{5, 6}

Accurate and complete documentation is essential for high-quality patient care. Written reports and ultrasound images/video clips that contain diagnostic information should be obtained and archived, with recommendations for follow-up studies if clinically applicable, in accordance with the AIUM Practice Parameter for Documentation of an Ultrasound Examination.⁵⁶

Adequate documentation is essential for high-quality patient care. There should be a permanent record of the ultrasound examination and its interpretation. Cine clips may be useful. Comparison with prior relevant imaging studies should be made and is helpful when available. Images of all appropriate areas, both normal and abnormal, should be recorded. Variations from normal size should generally be accompanied by measurements. Images should be labeled with the patient identification, facility identification, examination date, anatomic landmarks, and image orientation. An official interpretation (final report) of the ultrasound examination should be included in the patient's medical record. Retention of the ultrasound examination images should be consistent both with clinical need and with relevant legal and local healthcare facility requirements.

Equipment performance monitoring should be in accordance with AIUM Routine Quality Assurance of Clinical Ultrasound Equipment.⁵⁷

The sonographic examination of the female pelvis should be conducted with a real-time scanner, preferably using sector, curved linear, and/or endocavitary transducers. The transducer should be adjusted to operate at the highest frequency appropriate for clinical circumstances, realizing that there is a trade-off between resolution and beam penetration.

Policies and procedures related to quality assurance and improvement, safety, infection control, and equipment-performance monitoring should be developed and implemented in accordance with the AIUM Standards and Guidelines for the Accreditation of Ultrasound Practices.²

AIUM

Laura Detti, MD

Yvette Groszmann, MD, MPH

Lauri Silver Hochberg, MD

Elizabeth E. Puscheck, MBA, MD, MS

 

ACOG

Wendy Brewster, MD, PhD

Bethany Skinner, MD

 

ACR

Marcela Bohm-Velez, MD, Chair

Harris L. Cohen, MD

Malak Itani, MD

Arleen Li, MD

Michelle Melany, MD

Roya Sohaey, MD

 

SPR

Judy Estroff, MD

Jeffrey Tutman, MD

 

SRU

Rochelle E. Andreotti, MD

Nadia J. Khati, MD

Rachel Bo-ming Liu, MD, FACEP, FAIUM, Chair

Margarita V. Revzin, MD, MS, FSRU, FAIUM, Vice Chair

Tracy Anton, BS, RDMS, RDCS, FAIUM

Creagh T. Boulger, MD, FAIUM

John R. Eisenbrey, PhD, FAIUM

Rob Goodman, MB, BChir, FAIUM

Ethan J. Halpern, MD, FAIUM

Oliver Daniel Kripfgans, PhD, FAIUM

Juliana Gevaerd Martins, MD

John Stephen Pellerito, MD, FACR, FAIUM, FSRU

James M. Shwayder, MD, JD, FAIUM

Jean Lea Spitz, MPH, CAE, RDMS, FAIUM, FSDMS

 

 

Original copyright 1995; revised 1999, 2004, 2006, 2009, 2014, 2019, 2024; renamed 2015