Home

Pseudogestational sac treatment

Pseudogestational sac Radiology Reference Article

  1. al pain could be erroneously interpreted as a true gestational sac in ectopic pregnancy.. The sign was originally reported before the use of transvaginal ultrasound imaging and caution should be exercised if.
  2. That is, none of the fluid collections proved to be a pseudogestational sac. In total, 41.2% were live at the end of the first trimester, and 58.8% miscarried. The prognosis was better in cases with, compared to without, an IDS (P = .01, χ 2 ), but no ultrasound feature was clinically useful for ruling in or excluding a good prognosis
  3. Ectopic pregnancy. pseudo-sac. logistic regression. The impact of an ultrasound finding of a pseudo-sac (PS) on the diagnostic accuracy of ectopic pregnancy has not been formally evaluated. The ultrasound criteria for differentiating between an early intrauterine pregnancy and a PS have been previously reported (. 1
  4. A pseudogestational sac, an ectopic pregnancy, and an early pregnancy are important differential diagnoses to consider when evaluating an anembryonic pregnancy Expectant management, medical treatment with misoprostol, and surgical treatment are the three primary options for management Enhancing Healthcare Team Outcome
  5. tional sac and a pseudogestational sac (Table 1).5 The intra-uterine sac of our patient presented without yolk sac and/or an embryonal structure only slightly elongated and is roughly central within the endometrium. A double decidual sac was not clearly detectable. Taken together, we interpreted it as a pseudogestational sac (Figure 1A)
  6. Additionally, misdiagnosing a pseudo-gestational sac for an early IUP can lead to improper treatment. Note the irregular shape, lack of double decidual sign, presence of echoes in the fluid, and lack of embryonic contents in Pseudogestational Sac. Pseudogestational sac. Sagittal view of a pseudogestational sac. From Benson et al, 2013
  7. pseudogestational sac or decidual cyst: may be seen in 10-20% of ectopic pregnancies current evidence suggests that one should not initiate treatment for ectopic pregnancy in a haemodynamically stable woman on the basis of a single hCG value 1

Pseudogestational Sac and Other 1980s-Era Concepts in

That is, none of the fluid collections proved to be a pseudogestational sac. In total, 41.2% were live at the end of the first trimester, and 58.8% miscarried. The prognosis was better in cases with, compared to without, an IDS (P = .01,χ2 ), but no ultrasound feature was clinically useful for ruling in or excluding a good prognosis Puttagunta and Lee (2019) compared the main sonographic findings in a genuine gestational sac and a pseudogestational sac (Table 1). 5 The intrauterine sac of our patient presented without yolk sac and/or an embryonal structure only slightly elongated and is roughly central within the endometrium. A double decidual sac was not clearly detectable true gestational sac. However, this pseudogestational sac lacks a surrounding echogenic ring of chorionic villi, a yolk sac or fetal pole. An unruptured corpus luteum cyst or may be mistaken for an ectopic gestational sac, and a ruptured corpus luteum cyst may produce free pelvic fluid suggesting ruptured ectopic pregnancy This image shows a large pseudogestational sac of an ectopic pregnancy. This endovaginal ultrasonographic image demonstrates a subchorionic hemorrhage (SH) less than half the gestational sac size And the risk of treatment failure was increased 3.64 times (95% CI 1.56 to 8.49) in heterogeneous thick pattern and 4.24 times (95% CI 1.18 to 15.23) in pseudosac pattern. In conclusion, when tubal pregnancy was seen in a pseudogestational sac pattern or a heterogeneous pattern, the failure rate of medical treatment was increased

Ectopic pregnancy diagnosis and the pseudo-sac - Fertility

A normal-appearing gestational sac is smooth, round, or oval and is in the central portion of the uterus (other locations of the gestational sac should raise concerns for ectopic pregnancy). If intrauterine fluid collection is not round/oval, then a pseudogestational sac term can be applied Medical management with misoprostol is highly effective for early intrauterine pregnancy failure with the exception of gestational trophoblastic disease, which must be surgically evacuated... The impact of an ultrasound finding of a pseudo-sac (PS) on the diagnostic accuracy of ectopic pregnancy has not been formally evaluated. The ultrasound criteria for differentiating between an early intrauterine pregnancy and a PS have been previously reported 1, 2.In the absence of a yolk sac or a double decidual sac (DDS) the radiological differentiation between a failing intrauterine.

Not approved for use in pregnancy, yet is an invaluable medication widely used for cervical preparation for miscarriage, labor induction, and as a medical abortifacient Double decidual sac sign (gestational sac < 8 mm without yolk sac or fetal pole) Although the double decidual sac sign is considered diagnostic of IUP by experienced sonographers, it can easily be confused with the pseudogestational sac found in ectopic pregnancy (caused by breakdown of stimulated endometrial lining) and lead to incorrect. An empty gestational sac is a cavity within a uterus that forms to house a pregnancy but the embryo has stopped growing. This means that a fertilized egg was capable of implanting within the uterine wall to signal a pregnancy, but the embryo does not continue to develop and the pregnancy fails to progress. It is an early form of miscarriage

diameter. However, the mean gestational sac diameter may be recorded when an embryo is not identified. Caution should be used in presumptively diagnosing a gestational sac in the absence of a definite embryo or yolk sac. Without these findings, intrauterine fluid col-lection could represent a pseudogestational sac associated with an ectopic. In up to 20% of ectopic pregnancies, a pseudogestational sac, or an intrauterine endometrial fluid collection may be visible on ultrasound, and should not be mistaken for a viable IUP.3 A pseudogestational sac structure is characterized by a central location, oval shape, and lack of chorionic ring. The need for timely surgical intervention is. Presence of a yolk sac on transvaginal sonography is the most reliable predictor of single-dose methotrexate treatment failure in ectopic pregnancy. Journal of ultrasound in medicine: official journal of the American Institute of Ultrasound in Medicine. E. Kuligowska The age of the patient, size of the extraovarian mass, presence of a pseudogestational sac, and amount of free fluid did not correlate with outcome. CONCLUSIONS The presence of a yolk sac was always associated with treatment failure in single-dose MTX treatment of EP and was the most reliable predictor of failure among all features analyzed

Intrauterine findings of an EP include a normal endometrium, pseudogestational sac, trilaminar endometrium and thin-walled decidual cyst. A pseudogestational sac represents a thick decidual reaction surrounding intrauterine fluid. Ten percent of patients with an EP demonstrate a pseudogestational sac The intradecidual sign and the double decidual sac sign both have poor interobserver agreement and neither is required for the diagnosis of an IUP [7]. Before a yolk sac or embryo is seen, there has been concern that fluid in the endometrial cavity, sometimes termed a pseudogestational sac, might be confused for a gestational sac Anemia due to absence of oral food challenges. This may start from distal parts. Due to deficiencies of multiple organ dysfunction syndrome , a pseudogestational sac. Already low. canadian-pharmacy-in-dubai doxycycline hyc cap Clinsol gel for treatment of acne for can accutane permanently affect your gastrointestinal trac

Anembryonic Pregnancy Article - StatPearl

3) Treatment options for above differential diagnosis: Follow up (no identified yolk sac, wait for appropriate time frame, ie 10mm sac, etc) vs Treatment (exploratory laparotomy, D&C, Methotrexate. The pseudogestational sac of an ectopic pregnancy has only a single ring. The researchers have reported that 98.3% of all patients with a double-ring sac had an intrauterine pregnancy and 64 of 68 patients with a single-ring sac had ectopic pregnancies. Treatment failure is indicated by a less than 15% drop in hCG values between days 4 and. Outline , First question, Ectopic pregnancy, Ectopic pregnancy: risk factors, Ectopic pregnancy, Technique, Technique: EVUS, Ectopic pregnancy: ultrasound evaluation, IUP: intradecidual sign, IUP: double decidual sac sign, IUP: ultrasound diagnosis, Positive ßHCG/empty uterus Pseudogestational sac , Ectopic pregnancy, Extrauterine gestational sac, Tubal ring, Ectopic pregnancy Free fluid. mimics a gestational sac (the pseudogestational sac shown in Fig. 1, arrow), a sac alone cannot confirm intrauterine pregnancy.32 As the embryo matures, more sonographic signs become visible. Once the sac is implanted within the endometrium, its position relative to the endometrial wall changes, pro Ectopic pregnancy, in which the gestational sac is outside the uterus, is the most common life-threatening emergency in early pregnancy. The incidence in the United States has increased greatly in the last few decades, from 4.5 per 1000 pregnancies in 1970 to an estimated 19.7 per 1000 pregnancies in 1992.1, 2 Although spontaneous resolution of ectopic pregnancy can occur, patients are at risk.

Persistent increase of β‐hCG level after salpingectomy in

The patient has to be informed that a treatment effect by methotrexate is an increased abdominal pain, increased levels of HCG in the first 1-3 days of administration of the drug and some vaginal bleeding or spotting tendencies. This is to allay the feelings of fear and decrease the levels of anxiety during the treatment Operator Training Courses. The Office of Water Programs (OWP) is a nonprofit, self-supporting unit of University Enterprises, Inc., an auxiliary of California State University, Sacramento. We provide cost-effective distance learning training programs for individuals interested in the operation and maintenance of drinking water and wastewater. The age of the patient, size of the extraovarian mass, presence of a pseudogestational sac, and amount of free fluid did not correlate with outcome. Conclusions The presence of a yolk sac was always associated with treatment failure in single-dose MTX treatment of EP and was the most reliable predictor of failure among all features analyzed This is because the gestational sac can be confused with a pseudogestational sac, which is an endometrial fluid collection often associated with an ectopic pregnancy. 36 The pseudogestational sac is seen in 10% to 20% of ectopic pregnancies (Figure 4). 4 treatment of an IUP with methotrexate, misdiagnosed as an pseudogestational sac/decidual cystThere is an intrauterine fluid collection that is highly likely to represent a gestational sac. Ectopic pregnancy is far less likely..

A pseudogestational sac is centrally located whereas a true gestational sac is often eccentric in location, but the two can be confused on ultrasound. Other ultrasound findings seen with ectopic. A normal pregnancy should exhibit a gestational sac when beta subunit of human chorionic gonadotropin levels reach 1,500 to 2,000 mIU per mL (1,500 to 2,000 IU per L), a yolk sac when the.

Ectopic pregnancy | Image | Radiopaedia

Obstetric/OB Ultrasound Made Easy: Step-By-Step Guide

(Cytotec) or surgical treatment is more effective than expectant treatment. A 13-15 This distinguishes it from a pseudogestational sac asso-ciated with ectopic pregnancy A pseudogestational sac is a small fluid collection from an endometrial reaction to hormones produced by the ectopic pregnancy. This will appear within the endometrial cavity and can be seen in up to 20% of ectopic pregnancies. You MUST visualize at least a yolk sac within a gestational sac (located in the endometrium) before an IUP can be. Earliest marker of an IUP (can be seen usually around 4.5weeks gestation, when the HCG is at least 15000, and/or when the mean sac diameter is at least 3mm). Mimickers of an intrauterine gestational sac? Pseudogestational sac, ie 'Pseudosac' Decidual Cyst *You can have one of the above, or even (rarely) both, with an ectopic pregnancy b. Double decidual sac sign c. Correlation with β-hCG values d. Mean sac diameter (MSD) i) An average measurement of three dimensions of gestational sac D. Embryonic/Fetal Membranes 1. Chorion 2. Amnion 3. Vitelline stalk 4. Allantois E. Yolk Sac 1. Primary or primitive yolk sac 2. Secondary yolk sac a

Ectopic pregnancy Radiology Reference Article

Pseudogestational sac in an ectopic pregnancy. There is a single ring. Nyberg and colleagues 69 and Bradley and associates 70 have proposed morphologic criteria to distinguish the pseudogestational sac of ectopic pregnancy from the gestational sac of a normal intrauterine pregnancy sac with a fetal pole and with or without cardiac activity (13.2%) [18]. Ectopic pregnancies can cause the formation of a pseudogestational sac in the endometrium, which is a collection of fluid in the endometrial cavity caused by bleeding from the decidualized endometrium. A pseudogestational sac is cen-trally located whereas a true. The visualization of a yolk sac is the first definitive sign of an IUP . The yolk sac has the appearance of a brightly echogenic ring within the gestational sac (Fig. 15.4; eFigs. 15.6-15.8; VIDEOS 15.4 and 15.5) . Using current transvaginal ultrasound technology, the yolk sac can be seen at a gestational age of approximately 5 weeks The term pseudogestational sac should be avoided, because it implies the presence of an EP and turns attention away from the fact that in the pregnant patient, most intrauterine fluid collections are IUPs that could be harmed by inappropriate therapy. • The incidence of EPs in unusual locations is increasing Role of this exam is to rule in intrauterine pregnancy. Specificity of 92-100% for confirming intrauterine pregnancy (IUP) when gestational sac and yolk sac or fetal pole seen. 2. Ultrasound for early pregnancy should be performed when the patient has a pregnancy test to confirm location of pregnancy

Care should be taken not to mistake a pseudogestational sac for a true intrauterine pregnancy. A pseudosac is surrounded by only a single layer of hyperechoic tissue. This is in contrast with the finding of two hyperechoic rings surrounding the gestational sac in a normal intrauterine pregnancy - a feature known as the double decidual sign Pseudogestational sac: A pseudogestational sac can be confused with a gestational sac or with embryonic demise. An ectopic pregnancy may stimulate the endometrium, causing a fluid collection within the endometrium. Hemorrhage and hypovolemic shock ; Infection ; Loss of reproductive organs following surgery ; Infertilit sac diameter may be recorded when an embryo is not identified. Caution should be used in presumptively diagnosing a gestational sac in the absence of a definite embryo or yolk sac. Without these findings, an intrauter-ine fluid collection could represent a pseudogestational sac associated with an ectopic pregnancy What is a pseudogestational sac? 100. Folate antagonist used for treatment of ectopic pregnancies . What is methotrexate? 100. True or False. Sexual intercourse should be avoided during surveillance of an ectopic pregnancy. True . 200. The most common site of ectopic implantation

Pseudogestational Sac. No obvious yolk sac or fetal pole. Assessment/Plan: 32 year-old ICON positive female with acute-onset pelvic pain. The patient remained hemodynamically stable and absence of definitive IUP on bedside ultrasound was confirmed with presence of fetal cardiac activity in left adnexa indicative of ectopic pregnancy. OB-Gyn was. Highly suspicious for ectopic pregnancy: adnexal mass, tubal ring (gestational sac within the fallopian tube), pseudogestational sac (fluid collection in the endometrium without evidence of IUP), and/or large amount of free fluid in the pelvis and/or morison's pouch in the setting of no definitive intrauterine pregnancy

In ectopic pregnancies one may visualize a pseudogestational sac in which there will be only a single echogenic layer (instead of the two concentric echogenic rings of a true gestational sac) surrounding an intraendometrial fluid collection. Treatment: The most effective treatment of cervical pregnancy is unclear. Medical Treatment - single. tional sac. A pseudogestational sac may be seen in 10% of ectopic pregnancies and repre - sents a fluid collection that is centrally located within the endometrial canal [2]. Patients with a ruptured ectopic pregnancy often present with signs of shock, such as hypo-tension, tachycardia, rebound tenderness, and decreasing hematocrit [21]

UpToDat

Most cysts are noncancerous (benign), but sometimes cancer can cause a cyst. The gestational sac can usually be seen once your hCG levels are between 1500 and 2000. The pseudogestational sac is an intrauterine anechoic sac-like structure that may be mistaken for an early viable pregnancy. Learn more Salpingectomy is the definitive treatment. Though the incidence of ectopic is rising there is a drastic decrease in case fatality rate. Highly sensitive hCG assays and TVS helps in diagnosis at an early stage. Gestational sac with thick bright echogenic ringlike structure outside the uterus with fetal pole and yolk sac Pseudogestational sac. Gestational sac alone is NOT an IUP — could be pseudogestational sac (usually small, sometimes irregular, endometrial fluid collection) often seen with ectopic. Double decidual sign (two concentric echogenic rings around a gestational sac) is suggestive of, but NOT confirmatory for, IU

Endometrial cavity -A trilaminar endometial pattern seen -pseudogestational sac -decidual cyst may be seen PSEUDOSAC - All pregnancies induce an endometrial decidual reaction, and sloughing of the decidua can create an intracavitary fluid collection called a pseudosac Early gestational sac Pseudosac location below the midline echo along the. A yolk sac is the first visible structure within the gestational sac, and is a distinct circular structure with a bright echogenic rim and sonolucent center (Figure 3), and is recognized 3 wk post-conception (5 wk after the last menstrual period). The embryo is first recognized as a thickening along an edge of the yolk sac, and embryonic. Normal Thickness Of The Endometrium. The normal thickness of endometrium varies at different stages of the menstrual cycle in premenopausal women. The normal endometrial thickness measurements are (2): STAGES. THICKNESS. During menstruation. 2 - 4mm. Early proliferative phase (day: 6-14) 5 - 7mm The absence of the double decidual sac sign helps distinguish a pseudo-gestational sac from a true viable gestational sac (, Fig 7,) (, 26). In addition, a pseudo-gestational sac is located centrally within the endometrial canal, whereas a normal gestational sac is located eccentrically within the canal Ectopic b.Miscarriage c. Multiple pregnancy: Diagnosis & treatment (selective fetal reduction) 83. Ectopic pregnancy A. Uterine 1. No IU gestational sac 2. Pseudogestational sac (a fluid collection or debris in the cavity) 10-20% of ectopic P. No double decidual sac sign No yolk sac or embryo Not eccentric (within the cavity) 3

Fertility outcome after treatment of EP is one of the keystones when choosing treatment strategy. Only one randomized study has addressed this question ( 7 ). With a follow-up period of 18 months, Hajenius et al. reported a spontaneous intrauterine pregnancy rate of 36% following MTX and 43% after salpingotomy A pseudogestational sac lacks the double-sac sign and is smaller and more irregular than a true gestational sac at a comparable gestational age. The reader is encouraged to realize the limitations of the use of the term double-sac, since it can be misleading

OB 1st Trimester - Abnormal Findings. Pelvic Masses. Ovarian - Corpus Luteum. *Most common in 1st trimester. *Secretes progesterone - preserves the embryo. *Usually <5cm with no septations. *May hemorrhage (can look like septations) *Usually not seen after 16 weeks. *Surgery may be needed if persistent after 18 weeks 19yo G0, hCG negative, with pelvic pain and vaginal bleeding. Findings of lower abdominal tenderness, cervical motion/uterine/adnexal tenderness on examination, and low-grade fever are suggestive of PID. Other considerations include UTI, however, absence of dysuria, CVAT, and negative urine dip do not support this diagnosis Pseudogestational sac. This clip shows both an ectopic pregnancy in the adnexa as well as a pseudogestational sac in the uterus. These sacs are found in approximately 20% of ectopic pregnancies. They are located directly in the endometrial cavity, not eccentrically implanted like a normal gestational sac If an embryo or yolk sac is seen, then an intrauterine pregnancy is definitely present. it may be a pseudogestational sac associated with an ectopic pregnancy. The medical treatment of. A pseudogestational sac looks like an early gestational sac but lacks defining features of a normal pregnancy including an embryo or yolk sac; a pseudogestational sac is associ-ated with an ectopic pregnancy. M. IDDLETON ET AL., supra. note 3, at 307. 16. See . Vanitha N. Sivalingam, et. al., Diagnosis and Management of Ectopic Pregnancy.

How is incomplete miscarriage treated

The pseudogestational sac is an intrauterine fluid collection surrounded by a single decidual layer. 21 A normal gestational sac is covered by the decidual capsularis and Emergency Department Management of Cervicitis and Outpatient Treatment of Pelvic Inflammatory Disease (PID) 33,60 A. Cervicitis: Gonorrhea treatment: Ceftriaxone 125 mg IM. The gestational sac can be seen as early as 4-5 menstrual weeks, but an intrauterine pregnancy (IUP) cannot be confirmed until the secondary yolk sac is seen, typically at about 5-6 menstrual weeks. 4 Baun J: Ob/Gyn Sonography: An Illustrated Review. Pasadena, CA, Davies Publishing, 2016, p 8. 4 Gill KA: Gynecology Cranial anatomy visualized by 12-14 weeks. Caution diagnosis in 1st trimester. Follow up if suspected. Abdominal Wall Defect. Must be distinguished from normal bowel herniation. 8-12 weeks - echogenic mass in base of cord. Gastroschsis. Opening in anterior abdominal wall. Located to the right of UMB A so-called pseudogestational sac represents a small amount of intrauterine fluid (Fig. 9A), which can be misinterpreted as a true gestational sac in cases of ectopic pregnancy (Fig. 9B). It is estimated to be seen in 10% of patients with ectopic pregnancies [11]. Real-time observation of this phenomenon will often show Fluid in the uterus, which may be mistaken as a gestational sac (pseudogestational sac) Laparoscopic salpingectomy is the first-line treatment for ectopic pregnancy. This involves a general anaesthetic and key-hole surgery with removal of the affected fallopian tube, along with the ectopic pregnancy inside the tube..

The gestational sac (GS) is the first sign of early pregnancy on ultrasound and can be seen with endovaginal ultrasound at approximately 3-5 weeks gestation when the mean sac diameter (MSD) would approximately measure 2-3 mm in diameter. A true ge.. gestational sac and normal gestational sac. The pseudogestational sac is detected in the middle of the uterine cavity, its shape changes, owing to myometrial contractions. In differentiating a real gesta-tional sac from a pseudogestational one, transvaginal color and pulsed Doppler ultrasound proved to be very useful An intradecidual sac may also occur with an early ectopic pregnancy, where it is known as a pseudogestational sac; this represents a small fluid collection within the decidua that mimics a gestational sac. A more reliable ultrasound finding to help differentiate a pseudogestational sac from a gestational sac

A pseudogestational sac also may have clotted blood. Blood clots may appear as gray to white on the monitor. This may be misinterpreted as a fetal pole. Medical treatment with a cytotoxic agent, methotrexate (local or parenteral), or potassium chloride injected directly into the EP may be used. 41-46. Interstitial Pregnancy Referral pathways to local early pregnancy assessment units (EPAU) were in place for any woman in whom this early assessment was strongly suggestive of an EP, for example if there was an empty endometrial cavity and either an inhomogeneous adnexal mass or an empty extrauterine sac, or a yolk sac or fetal pole with or without cardiac activity in an extrauterine sac

A pseudogestational sac may be seen in 10% of ectopic pregnancies and represents a fluid collection that is centrally located within the endometrial canal . View larger version (293K) Fig. 1A —34-year-old woman with tubal ectopic pregnancy Early Diagnosis and Treatment of Ectopic Pregnancy D. Bukovi}1, M. [imi}2, M. Kopjar2, M. Zadro2, R. Fure{2, T. Viskovi}3 and J. Unu{i}4 ¹ University Hospital for Gynaecology and Obstetrics, Zagreb, Croatia ² Department of Gynaecology and Obstetrics,General Hospital Zabok, Zabok, Croatia ³ Health Center »Cvijeta Huis«, Zabok, Croati The first sign of pregnancy is the gestational sac, followed by a yolk sac, a fetal pole, and cardiac activity. While the earliest sign of pregnancy is a gestational sac, this finding in isolation should not be viewed as a definite intrauterine pregnancy. Intrauterine fluid can be seen with ectopic pregnancy, producing this pseudogestational sac Blood or pseudogestational sac in uterus can be differentiated from a true gestational sac by absence of the double decidual sign, yolk sac or fetal pole. [Figure caption and citation for the preceding image starts]: Ectopic pregnancy: Ultrasound image of ectopic pregnancy showing the donut sign From the personal collection of Dr Melissa Fries. Ectopic pregnancy • Definition : An ectopic pregnancy is one in which the fertilised ovum becomes implanted in a site other than the normal uterine cavity. • Extrauterine pregnancy -but rudimentary horn of a bicornuate uterus. • It is the consequence of an abnormal implantation of the blastocyst

]) once the gestational sac measures 8 mm to 13 mm, a yolk sac should be present on transvaginal scan. If identified, the yolk sac should be noted and measured. Very small yolk sacs, abnormally shaped yolk sacs, and yolk sacs greater than or equal to 5 mm, are associated with an increased risk of first trimester miscarriage and preterm labor Phillips CH, Benson CB, Durfee SM, et al. Pseudogestational Sac and Other 1980s-Era Concepts in Early First-Trimester Ultrasound: Are They Still Relevant Today? J Ultrasound Med 2020; 39:1547. Ackerman TE, Levi CS, Lyons EA, et al. Decidual cyst: endovaginal sonographic sign of ectopic pregnancy. Radiology 1993; 189:727 (22-3) However doub le decidual sac sign, or gestational sac <8 mm without yolk sac or fetal pole is in favor of the diagnosis of ectopic pregnancy. While considered diagnostic of IUP by experienced sonographers, this can be easily confused with the pseudogestational sac found in ectopic pr egnancy (caused by breakdown of stimulate The treatment of infertility is covered with review of complications such as ovarian hyperstimulation syndrome (OHS), multiple gestations, assisted reproductive technologies, and sonographic findings, and imaging pitfalls. In conclusion, pseudogestational sac, corpus luteum cyst, and diagnostic procedures are discussed. Core Concepts: 25. Pseudogestational sac Located centrally, unlike true gestational sac which is eccentric Does not have a yolk sac Absent double decidual sign IUP normal findings Yolk sac (TV): visible if MSD > 8 mm Fetal pole/embryo (TV): visible if MSD > 18 mm Heartbeat: MSD 16 mm, CRL 5 m

Innovations in Endovascular Aneurysm RepairAbdominal ultrasound | Fetal treatment center | UCSF RadiologyBursa Sac Foot « MedicineBTGUncommon Implantation Sites of Ectopic Pregnancy: ThinkingEctopic pregnancy BY DR SHASHWAT JANI

An empty uterine cavity (more common), a pseudogestational sac or decidual cast with an extra adnexal cyst/mass can be seen. The tubal ring and the ring of fire signs have been described and comprise an echogenic ring (95% PPV) and a ring of vascularity on colour Doppler that surrounds an unruptured ectopic pregnancy, respectively pseudogestational sac: false pregnancy: retractor: instrument used to hold wound edges and/or tissues apart during surgery: Rh negative: describes people with NO Rh antigen in the blood: Rh positive: describes people WITH the Rh antigen in their blood: RhoGAM: trade name for a preparation of Rh immune globulin required in an Rh-negative mothe Pseudogestational Sac Little or no value, avoid the term If definite ectopic pregnancy term has no value Otherwise, odds are strongly in favor of intrauterine gestation (99.9%) Report nonspecific fluid collection in uterus as almost certainly an intrauterine gestational sac Yolk Sac Usually seen on transvaginal ultrasound by 5.5 week Ectopic pregnancy. 1. Dr. Sourav Chowdhury Senior Resident. 2. DEFINITION Any pregnancy where the fertilised ovum gets implanted & develops in a site other than normal uterine cavity. It represents a serious hazard to a woman's health and reproductive potential, requiring prompt recognition and early aggressive intervention. 3 6.Nyberg DA, Laing FC, Filly RA, et al.: Ultrasonographic differentiation of the gestational sac of early intrauterine pregnancy from the pseudogestational sac of ectopic pregnancy. Radiology, 146; 755-761, 1983