Julie Rawlins Diagnostic Ultrasonographer T/A Inside Image Ultrasound

19/08/2026

Early Ultrasound Pregnancy 4-6 weeks

Here is a quick week-by-week guide to what we expect to see between 4 and 6 weeks of an intrauterine pregnancy on ultrasound

⏱️ Week 4:
What we see: A thickened endometrium with a tiny round intrauterine fluid collection

🍳 Week 5:
The First Proof What we see:
The yolk sac appears inside the gestational sac.
Appearance: It looks like a perfect little white ring.
This confirms the appearances of an intrauterine pregnancy and allows us to rule out an ectopic pregnancy

💓 Week 6: The Big Milestone
What we see:
The fetal pole (the early embryo) becomes visible next to the yolk sac. The Highlight: We can often see and measure a tiny, flickering heartbeat Size: The embryo is about the size of a sweet pea.

Every pregnancy develops at its own pace. Seeing these milestones depends heavily on precise ovulation timing

🗓️ When is the best time to book?

While early scans are exciting, it is highly advised to wait and schedule your confirmation scan for viability after 6 weeks. Waiting until this point ensures the structures are large enough to see clearly and allows us to reliably check for that beautiful flickering heartbeat!

Baby Imaging, 4 D scans, Prenatal Scans, Diagnostic Obstetric and Gynaecology Scans Abdominal Scans

29/04/2026

12 week NTT fetal ultrasound

At 12 weeks gestational age, the ultrasound NTT scan is a vital screening test that assesses your baby’s early development and helps identify the risk of certain chromosomal conditions. This detailed ultrasound also confirms gestational age, checks the heartbeat, and provides reassurance during a very important stage of pregnancy. Early assessment allows for informed decision-making and appropriate follow‑up care when needed.

Ultrasound NTT (Nuchal Translucency Thickness) Measurement
The NTT measures the thickness of the fluid-filled space at the back of the fetal neck during the 11–13+6 week ultrasound (when crown–rump length is 45–84 mm). It is taken in a strict mid‑sagittal view, with the fetus in a neutral position, and the maximum vertical thickness of the translucency is measured between the skin and the soft tissue overlying the cervical spine.
Normal values (general guidance):

NT increases slightly with gestational age and CRL.
At 11–13+6 weeks, an NT measurement is generally considered within normal limits if it is below the 95th percentile, which is approximately:

~1.2–2.0 mm at 11 weeks
~1.5–2.5 mm at 12 weeks
~2.0–2.8 mm at 13 weeks

An NT of ≥3.0–3.5 mm (depending on guidelines) is typically considered increased and associated with a higher risk of chromosomal conditions or structural anomalies, prompting further assessment.

NTT is a screening tool, not a diagnostic test, and is interpreted together with maternal age and, when applicable, blood markers to estimate overall risk.

For compassionate, professional imaging, contact Julie Rawlins – Diagnostic Ultrasonographer, t/a Inside Image Ultrasound, Hillcrest, Durban, KZN on 031 765 4670.

09/04/2026

🌸 Prioritize Your Health with Routine Pelvic Scanning 🌸

Routine pelvic scans are a vital part of proactive women's healthcare, allowing for the early detection of issues like cysts, fibroids, or other changes in the reproductive organs. Early diagnosis through regular check-ups ensures peace of mind and more effective treatment options for your long-term wellness. Book your screening today to stay ahead of your health!

Call 0317654670 to book your appointment

06/08/2025

Ultrasound of the Uterus : Endometrium

Endometrial thickness is a commonly measured parameter on routine gynaecological ultrasound and MRI. The appearance, as well as the thickness of the endometrium, will depend on whether the patient is of reproductive age or postmenopausal and, if of reproductive age, at what point in the menstrual cycle they are examined.

Radiographic features
Ultrasound
The endometrium should be measured in the long axis or sagittal plane, ideally on transvaginal scanning, with the entirety of the endometrial lining through to the endocervical canal in view 10. The measurement is of the thickest echogenic area from one basal endometrial interface across the endometrial canal to the other basal surface. Care should be taken not to include hypoechoic myometrium or intrauterine fluid in this measurement.

The normal endometrium changes in appearance as well as in thickness throughout the menstrual cycle:

in the menstrual and early proliferative phase it is a thin, brightly echogenic stripe comprising of the basal layer; minimal fluid can be appreciated endovaginally within the endometrium in the menstrual phase
in the late proliferative phase it develops a trilaminar appearance: outer echogenic basal layer, middle hypoechoic functional layer, and an inner echogenic stripe at the central interface
in the secretory phase it is at its thickest, up to 16 mm 10, and becomes uniformly echogenic, as the functional layer becomes oedematous and isoechoic to the basal layer; there is through transmission and posterior acoustic enhancement noted
The postmenopausal endometrium should be smooth and homogeneous.

Normal range of endometrial thickness

The designation of normal limits of endometrial thickness rests on determining at which thickness the risk of endometrial carcinoma is significantly increased.

Whilst quantitative assessment is important, endometrial morphology and the presence of risk factors for endometrial malignancy should also be taken into account when deciding whether or not endometrial sampling is indicated.

Premenopausal

In premenopausal patients, there is significant variation at different stages of the menstrual cycle.

during menstruation: 2-4 mm 1,4
early proliferative phase (day 6-14): 5-7 mm
late proliferative / preovulatory phase: up to 11 mm
secretory phase: 7-16 mm
following dilatation and curettage or spontaneous abortion:

25/06/2025

UTERINE FIBROIDS

Uterine leiomyomas, also known as uterine fibroids, are benign tumors of myometrial origin and are the most common solid benign uterine neoplasms. They are a common incidental finding on imaging and rarely cause diagnostic dilemma.

Fibroids may have a number of locations within or external to the uterus:

-intrauterine

-intramural leiomyoma: most common, centered within the myometrium

-subserosal leiomyoma: projecting outwards from the uterus; may be pedunculated and predominantly extrauterine, simulating an adnexal mass

-submucosal leiomyoma: least common (10-15%), projecting into the uterine cavity

-extrauterine

-broad ligament leiomyoma

-cervical leiomyoma

-parasitic leiomyoma

-diffuse uterine leiomyomatosis

Ultrasound is used to diagnose the presence and monitor the growth of fibroids:

-uncomplicated leiomyomas are usually hypoechoic, but can be isoechoic, or even hyperechoic compared to normal myometrium

-calcification is seen as echogenic foci with shadowing

-cystic areas of necrosis or degeneration may be seen

-Venetian blind artifact may be seen but edge shadowing +/- dense posterior shadowing from calcification is also typically seen

09/01/2025

POLYCYSTIC OVARIAN SYNDROME: PCOS

Polycystic ovaries (PCO) or polycystic ovarian morphology (PCOM) is an imaging descriptor of a particular type of change in ovarian morphology. A proportion of women with polycystic ovaries will have polycystic ovarian syndrome (PCOS), which in turn requires additional clinical, as well as biochemical, criteria; otherwise, polycystic ovaries can be considered a normal variant.

Epidemiology
Polycystic ovaries may be seen in ~20% of women of reproductive age 1,4.

Radiographic features
Ultrasound
Transvaginal ultrasound is considered the gold standard in the diagnosis of polycystic ovarian morphology (although not in adolescents 18). Features can affect either one (unilateral polycystic o***y) or both ovaries.

Features include:

increased follicle number per o***y (FNPO): ≥20

background ovarian enlargement (volume greater than 10 mL) excluding dominant follicle >10 mm or corpus luteum 7

10 antral follicles of 2-9 mm or more per slice (FNPS): ≥10

individual follicles are generally similar in size and measure 2-9 mm in diameter 7

peripheral distribution of follicles; this can give a "string of pearls" appearance

central stromal brightness +/- prominence (increased ovarian stromal area to total ovarian area (S/A) ratio 17)

Only one o***y fitting these criteria is sufficient to define PCOM. If there is evidence of a dominant follicle (>10 mm) or a corpus luteum, the scan should be repeated during the next cycle

01/09/2024

15/08/2024

Gender View scans

Ultrasound Gender Scan
This is probably the most common way that parents discover the s*x of their baby.There is normally a 100% accuracy gender prediction rate when over 16 weeks. This is usually a good timeline if you want to announce your baby’s gender to your friends and family or splash out on the blue or pink!
The s*x of the fetus becomes clearer to the sonographer as the baby gets bigger. If you have the patience to wait till 20 weeks, it is very clear to determine your baby’s gender at this stage.

To book your gender view scan contact :
Julie Rawlins- Diagnostic Ultrasonographer
Practice number 0390040517119
Tel: 0317654670
Cell: 0823217233
Heritage House Office Park: Vertebrae Wellness Vertebrae Chiropractic and Wellness Centre
20 Old Main Road
Hillcrest
KZN
[email protected]

Baby Imaging, 4 D scans, Prenatal Scans, Diagnostic Obstetric and Gynaecology Scans Abdominal Scans

07/08/2024

PELVIC ULTRASOUND

How often should a woman have a pelvic ultrasound?

It is recommend to have a routine gynaecological checkup with routine ultrasound pelvic screening every 1- 2 years.

**Book your screening pelvic ultrasound today-Julie Rawlins Diagnostic Ultrasonographer Tel: 0317654670 Hillcrest KZN / 0823217233**

Pelvic sonography is a screening tool and an important diagnostic modality for various gynecological and obstetric pathologies. Patients with abnormal uterine bleeding (AUB), postmenopausal bleeding, abdominal distension, palpable pelvic mass, abdominal pain, pelvic pain, infertility, recurrent pregnancy loss, and signs of infection should be evaluated by pelvic sonography.

Abnormal Uterine Bleeding

Heavy menstrual bleeding is one of the common presentations of structural uterine pathologies like leiomyoma, adenomyosis, and endometrial polyp detected by pelvic sonography. Patients with endometrial hyperplasia and carcinoma present with heavy menstrual and postmenopausal bleeding and require ultrasound screening. Intermenstrual bleeding is frequently associated with an endocervical polyp, carcinoma cervix, estrogen-secreting ovarian tumors, and intrauterine devices.
The most common presentation of endometrial carcinoma and hyperplasia in postmenopausal females is postmenopausal bleeding. Screening such females with pelvic sonography followed by endometrial sampling is highly recommended. Senile vaginitis, urethritis, and endocervical polyp are frequent causes of postmenopausal bleeding.

Abdominal Mass and Pelvic Mass

Ascites and ovarian malignancy frequently present primarily with complaints of increased abdominal girth, abdominal distension, and/or palpable pelvic mass. Large subserosal broad ligament leiomyoma, multiple uterine leiomyomas, adenomyosis with more than 12-week pregnant uterine size, molar pregnancy, rudimentary horn ectopic pregnancy, hematometra, pyometra, choriocarcinoma, ovarian and tubo ovarian mass present as pelvic mass frequently extending up to abdominal cavity. All these mentioned pelvic pathologies can be screened by pelvic sonography.

Pelvic Pain and Dysmenorrhea

Endometriosis, pelvic inflammatory disease, ovarian torsion, tubo ovarian mass, adenomyosis, degenerating leiomyoma, ectopic pregnancy, and cystitis are common pathologies presenting with lower abdominal and pelvic pain having an ultrasound diagnosis.

Infertility, Amenorrhea, and Recurrent Pregnancy Loss

Structural uterine anomalies in the case of the unicornuate uterus, bicornuate uterus, septate uterus, didelphys uterus, and cervical incompetence are associated with causing infertility and recurrent pregnancy loss. In patients with amenorrhea in case of androgen insensitivity syndrome (AIS) and Mayer-Rokitansky-Kuster-Kuster-Hauser (MRKH) syndrome due to absent uterus; due to hypoplastic uterus in case of Turner syndrome; and in case of imperforate h***n with hematometra, ultrasound diagnosis is required. These patients also have infertility.