How Ectopic Pregnancies Are Located With Ultrasound

 

Ultrasound Video showing Early Ectopic pregnancy with Ovarian Cyst and fluid in Morison’s pouch.

Video taken from the channel: Saeed Ahmad


 

“Ectopic Pregnancy” Ultrasound SonoWorld Lecture

Video taken from the channel: SonoWorld


 

Ultrasound Video showing an ectopic pregnancy with dead fetus.

Video taken from the channel: Saeed Ahmad


 

Evaluating for an ectopic pregnancy using Point of Care Ultrasound (POCUS)

Video taken from the channel: Medmastery


 

sonography of Ectopic Pregnancy

Video taken from the channel: Radiology Video


 

Sonographic Evaluation of Ectopic Pregnancy

Video taken from the channel: Radiology Video


 

3D Pathology Ectopic Pregnancy 1st Trimester TV

Video taken from the channel: Sonosite


To effectively rule-out an ectopic pregnancy via ultrasound, an intrauterine pregnancy (IUP) must be visualized. A A definitive IUP has a yolk sac or fetal pole in a gestational sac within the uterus (Figures 1 and 2). In very early pregnancy (less than 5 weeks), only a gestational sac will be seen in the uterus. A.

ABSTRACT. We present a rare case of cesarean scar ectopic pregnancy as diagnosed by transvaginal ultrasonography. Cases such as this are rare, but they are becoming more commonly detected with the growing frequency of cesarean sections, improving technology, and provider proficiency with point-of-care ultrasound. Ultrasonography is the diagnostic imaging study of choice for ectopic pregnancy.

Even if an ectopic pregnancy cannot be visualized on ultrasound, diagnosing an intrauterine pregnancy greatly reduces the risk of an ectopic pregnancy being present. Two ultrasonographical approaches exist for evaluation of ectopic pregnancy. Epidemiology. They are thought to represent 1% of all ectopic pregnancies 6 with an estimated incidence of 1:1000-10,000 births..

Pathology. It is often thought that they most frequently result from a tubal rupture with subsequent reimplantation of the conceptus onto bowel, omentum, or mesentery (in very rare situations primary abdominal ectopic may also occur). Ectopic Pregnancy Symptoms An ectopic pregnancy occurs when the fertilized egg attaches itself in a place other than inside the uterus. Most cases occur in the fallopian tube and are thus sometimes called tubal pregnancies.

The fallopian tubes are not designed to hold a growing embryo; thus, the fertilized egg in a tubal pregnancy cannot develop properly and must be treated. Bleeding from ectopic pregnancy causes 10% of all pregnancy-related deaths, and it’s the leading cause of first-trimester maternal death. A third of women with an ectopic pregnancy have a healthy pregnancy down the line. Women have a 15% chance of another ectopic pregnancy.

In more than 90% of cases, the egg implants in a fallopian tube. This is called a tubal pregnancy. Ectopic Pregnancy Signs and Symptoms. Most of the time, an ectopic pregnancy happens within the. Carrying out a vaginal ultrasound scan is also a dynamic process and allows the examiner to look at the mobility and tenderness of the organs in the pelvis – both of which are factors when considering a possible diagnosis.

Over 70% of ectopic pregnancies are seen on ultrasound on the first scan and well over 90% before surgery. An ectopic pregnancy is usually diagnosed by carrying out a transvaginal ultrasound scan. This involves inserting a small probe into your vagina.

The probe is so small that it’s easy to insert and you won’t need a local anaesthetic. The probe emits sound waves that bounce back to create a close-up image of your reproductive system on a monitor. Most ectopic pregnancies (90%) occur in the fallopian tube, which are known as tubal pregnancies, but implantation can also occur on the cervix, ovaries, or within the abdomen.

Detection of ectopic pregnancy is typically by blood tests for human chorionic gonadotropin (hCG) and ultrasound. This may require testing on more than one occasion.

List of related literature:

ULTRASOUND FINDINGS IN PATIENTS WITH SUSPECTED ECTOPIC PREGNANCY

“Emergency Medicine Secrets E-Book” by Vincent J. Markovchick, Katherine M. Bakes, Jennie A. Buchanan, Peter T. Pons
from Emergency Medicine Secrets E-Book
by Vincent J. Markovchick, Katherine M. Bakes, et. al.
Elsevier Health Sciences, 2010

This transabdominal transverse scan shows a large volume of intraperitoneal free fluid that must be considered an ectopic pregnancy until proven otherwise.

“Point of Care Ultrasound E-book” by Nilam J Soni, Robert Arntfield, Pierre Kory
from Point of Care Ultrasound E-book
by Nilam J Soni, Robert Arntfield, Pierre Kory
Elsevier Health Sciences, 2019

Under ultrasound guidance (imaging based on high-frequency sound waves), the physician inserts a needle through the uterine wall and amnion, into the amniotic cavity.

“The Language of Medicine E-Book” by Davi-Ellen Chabner
from The Language of Medicine E-Book
by Davi-Ellen Chabner
Elsevier Health Sciences, 2016

With transabdominal scanning, to diagnose an ectopic pregnancy by actually visualizing the fetus in a tube or the adnexa is rare (<10% of ectopic pregnancies).

“Pfenninger and Fowler's Procedures for Primary Care E-Book: Expert Consult” by John L. Pfenninger, Grant C. Fowler
from Pfenninger and Fowler’s Procedures for Primary Care E-Book: Expert Consult
by John L. Pfenninger, Grant C. Fowler
Elsevier Health Sciences, 2010

Ectopic pregnancy by transvaginal ultrasound of the right fallopian tube.

“Surgery: Basic Science and Clinical Evidence” by Jeffrey Norton, R.Randall Bollinger, Alfred E. Chang, Stephen F. Lowry
from Surgery: Basic Science and Clinical Evidence
by Jeffrey Norton, R.Randall Bollinger, et. al.
Springer Berlin Heidelberg, 2012

As many as 1% of pregnancies occur in ectopic locations, most commonly (⁓50% of cases) the fallopian tube (tubal pregnancy) because of obstruction from chronic inflammation and scarring of the oviduct, as may occur in pelvic inflammatory disease.

“Robbins Essential Pathology E-Book” by Vinay Kumar, Abul K. Abbas, Jon.C. Aster, Andrea T Deyrup
from Robbins Essential Pathology E-Book
by Vinay Kumar, Abul K. Abbas, et. al.
Elsevier Health Sciences, 2020

Referral of women with suspected ectopic pregnancies for ultrasound examination when available is suggested prior to vaginal examination.

“Obstetrics & Gynaecology: An Evidence-based Text for MRCOG, Third Edition” by David M. Luesley, Mark Kilby
from Obstetrics & Gynaecology: An Evidence-based Text for MRCOG, Third Edition
by David M. Luesley, Mark Kilby
CRC Press, 2016

The majority of ectopic pregnancies will be visualized on the initial ultrasound examination.

“Crash Course Obstetrics and Gynaecology” by Sophie Kay, Charlotte Jean Sandhu, Shreelata T Datta, Philip Xiu, Ruma Dutta, Fevzi Shakir
from Crash Course Obstetrics and Gynaecology
by Sophie Kay, Charlotte Jean Sandhu, et. al.
Elsevier Health Sciences, 2019

A transabdominal and transvaginal ultrasound examination with Doppler is the imaging test of choice for a suspected ectopic pregnancy, tubo-ovarian abscess, or ovarian torsion.

“Essentials of Radiology E-Book” by Fred A. Mettler
from Essentials of Radiology E-Book
by Fred A. Mettler
Elsevier Health Sciences, 2018

After penetration of the tubal musculature by the trophoblastic cells of the ectopic pregnancy, the muscle wall (top center and bottom left) weakens and ruptures, with extrusion of chorionic villi.

“Blaustein's Pathology of the Female Genital Tract” by Ancel Blaustein, Robert J. Kurman
from Blaustein’s Pathology of the Female Genital Tract
by Ancel Blaustein, Robert J. Kurman
Springer, 2002

Oktay Kutluk

Kutluk Oktay, MD, FACOG is one of the world's foremost experts in fertility preservation as well as ovarian stimulation and in vitro fertilization for infertility treatments. He developed and performed the world's first ovarian transplantation procedures as well as pioneered new ovarian stimulation protocols for embryo and oocyte freezing for breast and endometrial cancer patients.

Mail: [email protected]
Telephone: +1 (877) 492-3666

Biography: https://medicine.yale.edu/profile/kutluk_oktay/
Bibliography: oktay_bibliography

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  • 0:26 Protective sheath = Probe cover = Condom * Check for Latex Allergy, 0:56 Recto-Uterine Pouch = Pouch of Douglas = POD, 3:10 with Colour Doppler seen as “Ring of Fire” (Johnny Cash 1963) My work here is done. Excellent video btw