Radiology Lectures | Radquarters

Case of the Week: Ruptured Ectopic Pregnancy (Ultrasound)

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In this radiology lecture, we discuss the ultrasound appearance of ruptured ectopic pregnancy.

Key points include:

  • Most ectopic pregnancies occur in the fallopian tube: Ampulla most common, followed by isthmus and fimbria.
  • Risk factors: Prior ectopic pregnancy, prior surgery (fallopian tube), pelvic inflammatory disease, endometriosis, IVF.
  • “A single measurement of hCG, regardless of its level, does not reliably distinguish between ectopic and intrauterine pregnancy (viable or nonviable).”*
  • Levels of hCG in ectopic pregnancies are highly variable.
  • Tubal rupture main complication, occurs in up to 20%.
  • Free fluid in pelvis alone nonspecific, but echogenic fluid in Morison pouch (subhepatic space) and cul-de-sac raises concern for rupture.
  • Rupture is a relative contraindication to methotrexate (medical) therapy.

    • *Doubilet PM, Benson CB, Bourne T, et al. Diagnostic criteria for nonviable pregnancy early in the first trimester. N Engl J Med 2013;369:1443-51.

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    The post Case of the Week: Ruptured Ectopic Pregnancy (Ultrasound) appeared first on Radquarters.

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    Radiology Lectures | RadquartersBy Daniel J. Kowal, MD
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