MyPACS.net: Radiology Teaching Files > Case 10219116

Never visited COMPLETE ABORTION VS ECTOPIC PREGNANCY
Contributed by: Radiology Residency Program Faculty & Staff, Northeastern Ohio Universities College of Medicine-Canton Affiliated Hospitals, Ohio, USA.
Patient: 20 year old female
History: 20 y F pelvic pain and vaginal bleeding.
Images:[small]larger

Fig. 1: No IUP

Fig. 2: No IUP.
Findings: As in image legends.
Discussion: Role of Ultrasound and serum beta hCG level in Ddx and Dx of Pregnancy, abortion and ectopic pregnancy.

Beta hCG levels:

The discriminatory zone is the range of serum ß-hCG concentrations above which a gestational sac can be visualized consistently.

Tranvaginal US: 1,500 IU/L---> Gestational sac must be seen.

Empty uterus at this level: Ectopic pregnancy VS spontaneous abortion. Followup with US and serial beta hCG. In abortion, no sac is seen and hCG level drops. In ectopic pgy, signs of ectopic will be seen and hCG level is increased but less than normal pgy.

Normal early 1st trimester hCG should double every 2-3 days.

Empty sac with beta hCG < 1500 IU/L

3 possibilties:

1) Ectopic pregnancy
2) Spontaneous abortion
3) Normal early IUP

Beta hCG VS yolk sac and fetal heart rate

Yolk sac: 6000 UI/l (range 4500-7500);
Fetal hart motion: 10,000 UI/l (range 8650-12,200).

Review of US appearance of normal 1st trimester Pgy

1) Intradecidual sac sign: 4-4.5 wks
2) Yolk sac:                    5-5.5 wks
3) Heart                         6-6.5 wks

Normal Milestones

1) Yolk sac:     mean sac diameter >/= 10 mm
2) Fetal pole:   mean sac diameter >/= 18 mm
3) Fetal heart:  fetus >/= 5 mm

References: http://www.aafp.org/afp/20000215/1080.html
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Additional Details:

Case Number: 10219116Last Updated: 2007-08-29
Anatomy: Genitourinary (GU)   Pathology: Other
Modality: USAccess Level: Readable by all users

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