First
trimester
Preparation
Scans are performed though the full bladder using a 5 MHtz curvilinear probe.
Indications for first trimester sonography
5-12 weeks
Following are sonographic features
of ectopic pregnancy.
Specific features
Should consist the following.
1.GS
3.Conclusion
Indications
- Bleeding after a POA
- Pain during pregnancy
- Pregnancy complicated by fibroid or ovarian cyst
Scans are performed though the full bladder using a 5 MHtz curvilinear probe.
Indications for first trimester sonography
- Localization of the GS –Intra uterine or Ectopic pregnancy
- Identification of foetal viability
- Anovular gestation
- Estimation of POG
- Assessment of multiple pregnancy, number of embryos chorionicity & amniocity
5-12 weeks
-
Well-defined gestational sac/sacs (well defined hypo echoic rounded structure) with fetal yolk sac (separate hypo echoic area within the GS outlined by an echogenic ring) & foetal echoes (oval shaped echogenic area) are located in the fundus of the uterus.
- Yolk sac identified when the mean sac diameter is > than 8mm.
- Heart pulsations identified during by trans vesicle scan fetal cardiac pulsations should be present when fetal CRL is > 7mm
- Abnormal GS size (Growth failure growth rate of the sac is 1.1mm /day, blighted ovum - mean gestational sac > 20mm with out yolk sac & fetal echoes)
- Absent yolk sac & absent or in compatible fetal echoes
- Ill-defined or deformed GS & low implantation
- Ill defined placenta & /or disorganized intra uterine
- Echoes (Missed abortion or H mole)
- Double or triple sacs like structures with in the uterus.
- GS outside the uterus (Ectopic pregnancy)
Ectopic
pregnancy
Specific features
- Live embryo outside the uterus
-
Empty uterus
- Pseudo gestational sac of ectopic pregnancy
- Particulate ascites
- Adenexal mass
- Ectopic tubal ring
- Negative β- hCG
- Live intrauterine pregnancy
Report
Should consist the following.
1.GS
- Whether the GS is intrauterine or extra uterine should be documented.
- If intra uterine site of the GS whether it is in the fundus, body or cervical region of the uterus, number of sacs, & whether foetal echoes are present or absent should be documented.
- GS size should be measured & documented. Whether heart pulsations & movements present or absent should be documented.
2.Adenexa & pouch of Douglas
-
Cysts, masses, free fluid or other abnormalities should be looked for & documented.
3.Conclusion
-
Normal intrauterine pregnancy
- Abnormal intrauterine pregnancy
- Ectopic pregnancy (ruptured or un ruptured)
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