First Trimester Pregnancy

Question 1

Definition of IUP

Answer 1

1. decidual reaction
2. yolk sac/fetal pole
3. gestational sac
4. myometrial mantle >8mm

Question 2

When should you expect to see an IUP on US?

Answer 2

When should you expect to see an IUP on US?
- Trans-vaginal: bHCG >1500
- Trans-abdominal: bHCG > 4000-6000
- Cutoffs can be highly variable!
▸ If NDIUP above these levels, consider ectopic

Question 3

what is heterotopic pregnancy

Answer 3

combined intrauterine and ectopic pregnancy.

Question 4

DDx for gestational sav being visualized but no pregnancy

Answer 4

DDX: PIMEA
Pseudogesational sac in ectopic pregnancy
IUP
mass
anembryonic pregnancy.

Question 5

What is an anembryonic pregnancy

Answer 5

▸ Positive bHCG (higher than expected for GA) ▸ Large gestational sac (> 25 mm)
▸ No yolk sac or fetal pole inside
▸ Needs f/u radiology US

Question 6

if IUP and fetal HR is seen in first trimester bleeding case, the risk of pregnancy loss is ___

Answer 6

if IUP and fetal HR seen, the risk of pregnancy loss is 5% vs 92.75%.

Question 7

to make sure the pregnancy is not ectopic, how thick should the myometrial mantle be?

Answer 7

8mm– if its smaller it is possible its an interstitial or cornual pregnancy.