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The first 25 slides, exactly as they appear. The full deck has 110 content slides.
Radiology
Pregnancy of Unknown Location, Early Pregnancy Loss, Ectopic Pregnancy, and Cesarean Scar Pr
Built from Obstetric Imaging
What’s inside
9 sections · 110 slides
Overview
- What this deck covers
Why the first scan matters
Pregnancy is an inefficient process, and the earliest weeks carry the highest risk of getting the diagnosis wrong.
- Early pregnancy is fragile
- Two questions every early scan must answer
- The four diagnoses in this topic
- Where an early pregnancy can end up
- Accuracy beats speed
Pregnancy of unknown location
A positive test with an empty-looking scan is a stage, not a disease.
- What pregnancy of unknown location means
- Every pregnancy starts as unknown location
- Why the scan can look empty
- Milestones of the first weeks
- Developmental Milestones of Early Pregnancy, Ultrasound Findings, and Correlation to Beta-Human Chorionic Gonadotropin Levels
- Why the hormone number alone misleads
Normal landmarks in early pregnancy
Sac, yolk sac, embryo, heartbeat - learn the order and the sizes.
- The lining thickens before anything is visible
- The gestational sac
- Chorionic sac inside a bright decidual reaction
- When the sac becomes visible
- Dating from the sac
- The look-alike: pseudosac
- The yolk sac
- Yolk sac, embryonic pole and a measured heart rate
- The embryo appears
- Measuring the embryo
- The heartbeat
- M-mode tracing of an early fetal heart rate
- The order things appear in
Working up an unknown location
Scan technique, the corpus luteum trap, and what to do while you wait.
- How these patients present
- Choosing the probe
- Doppler: useful but used sparingly
- Ring of fire around the corpus luteum
- What the scan shows in unknown location
- Where MRI fits, and what the classic picture is
- The waiting pathway when the patient is stable
- Adding progesterone to the triage
- When waiting must stop
Early pregnancy loss
Common, rarely anyone's fault, and easy to over-diagnose.
- What early pregnancy failure means
- How common it is
- Why pregnancies fail
- The other contributors
- What to tell the patient
- How a loss presents
- Matching the bedside picture to the scan
- First-trimester bleeding and early pregnancy loss: clinical findings
- First-trimester bleeding and early pregnancy loss: ultrasound findings
- Three ways a loss looks on ultrasound
- Empty sac and abnormal yolk sacs in failed pregnancy
- Sac and yolk sac clues
- Signs you can rely on
- Guarding against a false diagnosis
- Seeing a heartbeat is reassuring
- 4.5%
- When the heart beats too slowly
- Blood collecting beside the sac
- Treating incomplete miscarriage and retained tissue
- When the tissue has not passed
- Two checks before any plan
Ectopic pregnancy
A pregnancy growing outside the uterus - the diagnosis that must not be missed.
- What ectopic pregnancy means
- Where they sit and who is at risk
- Why it happens
- Four locations, four scan pictures
- Ectopic pregnancy locations: where each one sits
- Ectopic pregnancy locations: what the scan shows
- Ectopic pregnancy locations: points to remember
- A tubal ectopic pregnancy
- Interstitial ectopic pregnancy on two-dimensional and three-dimensional views
- Why the interstitial type is dangerous
- Cervical ectopic pregnancy
- How an ectopic presents
- The cervical ectopic is different
- Imaging and the classic picture
- Treating an early tubal ectopic
- Treating interstitial and cervical pregnancies
- Stable or unstable decides the route
- Balloon tamponade and the safety rule
- What the referring clinician needs to know
Cesarean scar pregnancy
Implantation on an old scar - and the earliest sign of a placenta that will not let go.
- The scar and the niche
- What a cesarean scar pregnancy is
- Is it really an ectopic pregnancy?
- How often it happens
- Why the scar is vulnerable
- One proposed route from scar to scar pregnancy
- How it presents
- How to take the picture
- Cesarean scar pregnancy on transabdominal and transvaginal scans
- Diagnostic criteria: position
- The sac that seems to climb
- Diagnostic criteria: muscle and contents
- Blood flow marks the implantation site
- Three-dimensional reconstruction of a scar pregnancy
- MRI and the classic picture
- Look-alike 1: a miscarriage passing through
- Look-alike 2: a cervical pregnancy
- Telling the two apart
- How scar pregnancies are treated
- Counselling when there is a yolk sac but no embryo
- Counselling when there is a heartbeat
- Screening the next pregnancy
- Key points on scar pregnancy
Pulling it together
What to carry away from the first-trimester scan.
- Take-home: the sequence
- Take-home: numbers worth keeping
- Take-home: the traps
- References
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- Obstetric Imaging: Fetal Diagnosis and Care, 2nd Edition