Pellentesque habitant morbi tristique senectus et netus et malesuada fames ac turpis egestas. Vestibulum tortor quam, feugiat vitae, ultricies eget, tempor sit amet, ante. Donec eu libero sit amet quam egestas semper. Aenean ultricies mi vitae est. Mauris placerat eleifend leo.


Ectopic Pregnancy

1st trimester pregnancy with irregular bleeding, abdominal or pelvic pain, tender adnexal mass; hCG doubles every 2 days in normal pregnancy

DDx of positive pregnancy test

When pregnancy test is positive, the ONLY finding that rules out ectopic pregnancy is the detection of an IUP.

When pregnancy test is positive and there is no evidence of an IUP, ANY adnexal finding other than intra-ovarian cyst should be considered an ectopic pregnancy until proven otherwise.

Location of Ectopic pregnancy

Pseudogestational sac

Collection of fluid or echogenic material (decidual cast) within the endometrium (IUP fake out), 5% of ectopics

Decidual cysts

In the periphery of hyperechoic endometrium; associated with ectopic pregnancy

Interstitial (cornual) pregnancy

Eccentrically positioned within the most lateral portion of the uterine fundus; Interstitial line sign: Hyperechoic endometrial line abuts on the midportion of the sac rather than going around it

Adnexal Ectopic Pregnancy