Test yourself
Ectopic pregnancy: empty uterus? Find the adnexa
4 questions. Pick an answer to see whether you are right and why. Your score appears at the end.
Question 1What must a sac in the uterus contain before you call an intrauterine pregnancy on POCUS?
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Answer a. A gestational sac alone can be a pseudosac. A yolk sac or fetal pole inside a sac within the uterus confirms an intrauterine pregnancy.
Question 2How does a pseudosac differ from an early gestational sac?
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Answer a. A pseudosac is fluid or blood in the cavity itself. A true early sac implants within the endometrium, to one side of the cavity line.
Question 3A hypotensive patient with a positive pregnancy test has free fluid in Morison's pouch. What does this suggest?
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Answer b. Free fluid reaching the right upper quadrant in early pregnancy with shock suggests a large bleed. Resuscitate and involve gynaecology for theatre immediately.
Question 4A stable patient has a positive pregnancy test, mild pain and an empty uterus on POCUS with no adnexal mass or free fluid. What is the diagnosis?
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Answer a. An empty uterus does not exclude ectopic pregnancy or confirm miscarriage. The patient needs formal transvaginal scanning and serial hCG.
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Four or five delegates per instructor, FAMUS-accredited faculty and long, supervised time on the probe.
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