Page 97 - PCC05

Recommendations for ultrasound in early pregnancy
• Exercise extreme caution with regard to last menstrual period on history taking
• Visualise all of the uterus
• Scan the adnexae not to miss heterotopic pregnancy or adnexal
masses
• Avoid labelling subchorionic bleeds as additional gestational sacs
• Beware of pseudosacs
• Do an additional abdominal scan in case of a fibroid uterus
When no pregnancy is visualized: Prediction models
Mathematical Models
Model M1 Model M2 Model M3
Model M4
hCG ratio (hCG 48 hr/hCG 0 hr) log progesterone average
Age
log progesterone average hCG ratio
hCG ratio
log average of the two hCG levels
Condous et al, Hum Reprod 2004 Condous et al, UOG 2007
Van Calster et al, AIM 2009
Detection rate for ectopic of 88%
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