This diagnostic image is a transvaginal ultrasound (TVUS) of the uterus in a 36-year-old patient, performed as a post-procedural evaluation following dilatation and curettage (D&C) for a partial molar pregnancy. The uterus is visualized in a sagittal or longitudinal plane, appearing as a roughly pear-shaped or fan-shaped structure with mixed mottled echogenicity of the myometrium. A white arrow points to the endometrial cavity, which reveals a thin, regular, and linear hyperechoic (bright) endometrial stripe. This finding is clinically significant as it confirms the successful evacuation of gestational tissue and the absence of retained products of conception (RPOC). The image serves as an educational example of normal post-operative uterine morphology and the baseline appearance of the endometrium during the follow-up of gestational trophoblastic disease (GTD).

This diagnostic imaging panel consists of coronal (a-c) and axial (d) images from a post-contrast venous phase fat-saturated T1-weighted MR venogram of the abdomen. The case illustrates bilateral ovarian (gonadal) vein thrombosis in a 35-year-old post-partum patient following dilatation and curettage. Image (a) identifies the post-partum uterus (curved arrow). Images (b) and (c) demonstrate marked dilatation of the right and left gonadal veins (straight arrows) with prominent central filling defects, indicating intraluminal thrombus. In image (c), a curved arrow highlights the superior extension of the thrombus reaching the juxtarenal inferior vena cava (IVC). The axial image (d) provides a cross-sectional view of the expanded gonadal veins bilaterally, clearly showing the low-signal intensity central thrombi surrounded by peripheral contrast enhancement (straight arrows). This study demonstrates a rare but serious post-partum complication involving extensive pelvic venous thrombosis and its pathway toward the central venous system.

This diagnostic image is a transabdominal ultrasound of the pelvis, focusing on the uterus. The scan reveals a significantly enlarged uterine cavity filled with complex, heterogeneous tissue. The echotexture is characterized by a 'snowstorm' appearance, consisting of numerous small, hypoechoic (cystic) spaces interspersed with hyperechoic (echogenic) areas, suggesting solid components or blood clots. The margins of the intrauterine mass are irregular and poorly defined, with no evidence of a healthy gestational sac or normal endometrial strip. This visual presentation is highly characteristic of gestational trophoblastic disease (GTD), such as a hydatidiform mole. The image demonstrates the clinical utility of real-time ultrasound guidance during a dilatation and curettage (D&C) procedure to monitor the evacuation of abnormal uterine contents and ensure the safety of the uterine wall. The primary educational focus is the sonographic identification of abnormal molar pregnancy tissue and the management of high-beta-hCG pelvic masses.

This color Doppler ultrasound image in the longitudinal plane displays the uterus of a 28-year-old female patient with a history of recent dilation and curettage (D&C). The image demonstrates enhanced myometrial vascularity (EMV), characterized by a focally increased color Doppler signal (indicated by a white arrow) spanning the full thickness of the anterior myometrium. This vascular signal extends directly into the endometrial cavity, which appears distended with isoechoic material. The color flow manifests as a complex mosaic of red and blue hues, indicating multidirectional, high-velocity blood flow within the myometrial wall. This clinical presentation and imaging finding are highly suggestive of retained products of conception (RPOC) or an acquired uterine arteriovenous malformation (AVM) secondary to pregnancy-related procedures. The imaging modality provides critical diagnostic information for differentiating between physiological postpartum changes and pathological vascular conditions requiring medical or surgical intervention.

A series of six intraoperative endoscopic photographs (A-F) documenting a coaxial-robotic single-site myomectomy (C-RSSM). Panel (A) shows the initial robotic camera view of the uterus with surgical instruments positioned at the pelvic cavity. Panel (B) depicts the uterine serosal incision and the application of traction and countertraction to the intramural myoma. Panel (C) demonstrates the use of a robotic tenaculum grasper for powerful traction during the enucleation process. Panel (D) reveals the resulting uterine defect (cavity) after the myoma has been fully enucleated, showing visible hemorrhagic tissue within the bed. Panel (E) illustrates the reconstructive phase, where a mega-needle driver is used to perform layer-to-layer suturing of the uterine wall with barbed sutures. Panel (F) displays the final post-procedural state with the uterine defect successfully closed and anatomical integrity restored. The images highlight the limited range of motion and instrument positioning characteristic of single-site robotic gynecological surgery.

This diagnostic image is a transabdominal ultrasound in the sagittal plane, demonstrating ultrasound-guided intrauterine instrumentation. The scan shows two distinct, hyperechoic linear structures entering the uterine cavity. A white arrow identifies a suction curette, which is seen threaded over a secondary hyperechoic linear guide, indicated by a black arrow as a 10-French intubating stylet. A white asterisk (*) marks the uterine fundus, the intended anatomical destination within the uterine cavity. The surrounding myometrium and pelvic tissues exhibit heterogeneous echogenicity with characteristic speckled artifact. The image illustrates a clinical technique used to navigate difficult anatomy or false tracts (such as uterine perforation sites) by using a shaped stylet as a guide for the curette. This educational visual is relevant for obstetrics and gynecology, specifically regarding complications and management during surgical abortion or dilation and curettage (D&C) procedures.

This composite of six intraoperative clinical photographs (a-f) illustrates the surgical steps of the cervical inversion technique used to manage massive hemorrhage from the placental bed. (a) Initial view of the surgical field showing active bleeding from the placental implantation site. (b) Traction and inversion of the cervical lips using two Allis forceps. (c) Insertion of a Hegar dilator into the cervical canal to maintain patency during reconstruction. (d) Suturing of the posterior cervical lip to the posterior wall of the lower uterine segment. (e) Suturing of the anterior cervical lip to the corresponding anterior wall of the lower uterine segment, effectively creating a surgical tamponade. (f) Final stage showing the removal of the Hegar dilator with the cervical inversion completed. This procedure is a conservative surgical intervention for placenta previa or accreta to achieve hemostasis while preserving the uterus. The images demonstrate the use of standard surgical instruments, including forceps, dilators, and needle drivers, in an acute obstetric surgical context.