Have an account? Please log in.
Text size: Small font Default font Larger font
Radiology Daily
Radiology Daily PracticalReviews.com Radiology Daily

Ectopic Pregnancy Part 5

March 12, 2009
Written by: , Filed in: Obstetric Ultrasound
  • Comments

I want you to be aware of the large ectopic pregnancy in ultrasound.

If you look at a case and start to measure the biparietal diameter of this fetus, you’re in trouble, because the actual uterus is here and the endometrial cavity is here. So large size is something that doesn’t necessarily mean that pregnancy must be in the uterus.

Also very important is that there is no mass and no fluids. So you might have a patient at risk, you look and you are unable to demonstrate an interuterine pregnancy, and that brought her risk to greater than 50/50.

If in that same patient you cannot find a mass or any fluid, you have to remember that she still carries a modest risk for ectopic pregnancy ranging from 7% to 33%.

So the inability to see adnexal findings did reduce her risk, but it didn’t reduce her risk to a level that is acceptable. The patient is still at risk for ectopic pregnancy.

So when you see no intrauterine pregnancy and no adnexal mass or fluid, you cannot exclude ectopic pregnancy.

So remember, if the patient is clinically suspected of harboring an ectopic pregnancy and has a positive pregnancy test, her risk is about 15%, about 10% higher than the average woman in the U.S. population who is pregnant.

If you do a sonogram and are able to demonstrate an intrauterine pregnancy, you effectively take the woman out of the group at risk for ectopic pregnancy.

If you show no intrauterine pregnancy, you increase her risk to over 50/50.

From that point you can subsequently increase her risk anywhere from 75% to 100% by demonstrating fluid, mass or an embryo in her adnexa, but at no point subsequently can you bring her risk down to 0, because a significant number of these patients still have an ectopic pregnancy.

Author: Roy A. Filly, MD
Excerpted from:
Diagnostic Imaging Review: For Residents, Fellows and Radiologists
Female Pelvis Section

Women’s and Breast Imaging

New York University Post-Graduate Medical School and the Department of Radiology This course is designed for the practicing radiologist with particular interest in women’s imaging and breast imaging. During the women’s imaging segment, the participating faculty will discuss each of the imaging modalities applied to obstetrical and gynecological imaging including ultrasound, MRI and CT. Practical and multimodality approaches to common imaging problems in the female pelvis will be emphasized, including imaging of the patient with pelvic pain, evaluation of adnexal masses and assessment of benign and malignant disorders of the uterus. Topics in obstetrical imaging will include requirements for the sonographic fetal anatomic survey, sonographic evaluation of obstetrical emergencies, normal and abnormal first trimester pregnancy and imaging pitfalls. The role of MR and CT in the evaluation of the pregnant patient will also be discussed. Click here to read more or order: Women’s and Breast Imaging

Permalink: http://www.radiologydaily.com/?p=1064

Tags: , , , , , , , , , , , , , , , , ,

  • Comments

Would you like to keep current with radiological news and information?

Post Your Comments and Responses

Comments are closed.