if EP is in the (a)   portion of the fallopian tube near the uterine cornu => increased risk for massive hemorrhage with rupture=> lead to hysterectomy or even death

One of most emergent diagnoses made with US

(a)  

(a)   % of of maternal deaths are related to EP

1. Rise in incidence of pelvic infections

2. Use of intrauterine contraceptive devices (IUCDs)

3. Fallopian tube surgeries

4. Infertility treatments

5. History of ectopic pregnancy

(a)  

Pain is reported in (a)   % of patients, may be consistent with appendicitis or PID

Vaginal bleeding, empty uterus, presence of adnexal mass, and a positive pregnancy test is found in (a)   % of cases

in a normal pregnancy: β-hCG level doubles every (a)   hours until it reaches 10,000-20,000 mIU/mL

in a normal pregnancy: β-hCG level doubles every 48 hours until it reaches ___-___ mIU/mL

(a)  

in EP: β-HCG levels usually increase (a)  

Mean serum β-HCG levels are (a)  

Serial beta-hCG levels are preferred when it comes to (a)  

These images both show

(a)  

20% of patients with EP demonstrate intrauterine saclike structure known as

(a)  

Pseudo GS is located (a)   within the endometrial cavity, normal GS are eccentrically located

(a)   level echoes are commonly observed in pseudo GS

This image shows a (a)   in the LT adnexa

These images all show

(a)  

A recent spontaneous abortion could indicate a (a)   uterus

No peritrophoblastic flow is characteristic of a (a)  

Simultaneous intrauterine pregnancy and ectopic pregnancy (see findings above for IUP and ectopic pregnancy)

(a)  

Pseudogestational sac

• Extrauterine sac in adnexa with thickened echogenic ring

(a)  

•No yolk sac in the uterus

•Possible yolk sac outside uterus

(a)  

Located outside the uterine cavity in that part of the fallopian tube that penetrates the muscular layer of the uterus

(a)  

• Rupture with hemorrhage

• Eccentric intrauterine gestational sac with incomplete myometrial mantel surrounding sac

(a)  

•Pseudogestational sac of ectopic pregnancy

(a)  

Identification of live embryo within adnexa is most specific for

(a)   gestation ( occurs ~ 25% of the time)

Only approximately (a)   % of live ectopic pregnancies identified using transabdominal sonography

What is one of the most frequent findings of EP?

(a)  

Thickened echogenic ring, separate from ovary, which represents trophoblastic tissue or chorionic villi

(a)  

Complex adnexal masses, aside from extrauterine GS, often represent (a)   in peritoneal cavity

80% of patients with EP demonstrate at least (a)   ml of blood within the peritoneum (blood escaping from the distal tube - fimbria)

~ (a)   % of women with EP demonstrate intraperitoneal fluid by TVS transvaginal sonography

Presence of (a)   - highly specific for hemoperitoneum and to be highly correlated with EP

The combination of an __ and __ fluid is the most precise sonographic correlation in the diagnosis of EP

(a)  

This shows

(a)  

This shows

(a)  

Simultaneous intrauterine and extrauterine pregnancies are extremely uncommon, even in patients undergoing an infertility workup

(a)  

An Interstitial pregnancy is (a)  

in segment of fallopian tube that enters uterus which involves parauterine and myometrial vasculature, creating life- threatening hemorrhage when rupture occurs

(a)  

Interstitial pregnancies occur (a)   % of all EP

Described as an eccentrically placed GS within the uterus that has an incomplete myometrial mantle surrounding the sac (some institutions measure the myometrial thickness and follow these implantations carefully for evidence of myometrial thinning and

uterine rupture)

(a)  

These images show (a)  

Cervical pregnancies are extremely (a)  

Concentric shape with decidual reaction and increased color Doppler flow around the trophoblast.

(a)  

misshapen sac, possibly hour-glassing (the hour-glass sign)

through the cervical os, with lack of color flow around the decidual ring

(a)  

reported cases have demonstrated complex adnexal masses that involve or contain the ovary

(a)  

distinguishing ovarian pregnancy from a hemorrhagic ovarian cyst

or from other ovarian processes may be difficult.

(a)  

Maximum thickness of subcutaneous lucency at back of neck in embryo at 11 to 14 weeks’ gestation

(a)  

An (a)   NT measurement is associated with trisomies T 21, T 13 and T 18

and in fetuses with cardiac defects and other genetic syndromes

NT measurement combined with biochemical markers—free beta- hCG and pregnancy-associated plasma protein (PAPP-A)—to assess risk for (a)  

This shows (a)  

This image shows an (a)   nuchal translucency

Fetuses must be between __ and __ 6 days for Nuchal Translucency

(a)  

CRL must be __ and __ for nuchal translucency

(a)  

Sonographer must obtain optimal image of Nuchal translucency (a)  

Embryo must be (a)   from amniotic membrane with head in neutral position, no hyperextension or flexion

✓ Nuchal thickening

✓ Presence or absence of nasal bone

✓ Tricuspid regurgitation

✓ Abnormal flow in ductus venosus

✓ Possibly abnormalities of hindbrain

(a)  

Strong relationship between increased NT and fetuses with (a)  

Ability to detect four-chamber view and great vessels as early as (a)  

✓ Increased Nuchal translucency

✓ Tricuspid regurgitation

✓ Reversal (or absence) of flow in Ductus Venosus

(a)