Ectopic Pregnancy

This week’s images are brought to us by Drs. Deepa Patel and Joshua Wallenstein who made the bedside diagnosis of ectopic pregnancy using transvaginal ultrasound. The first image is a sagittal section through the uterus obtained using the intracavitary probe with the indicator towards the ceiling. Here we can’t see a definitive IUP- defined as a gestational sac with either a yolk sac or a fetal pole. We can also see a small amount of free fluid in the pouch of Douglas, posterior to the uterus.



Scanning through the pelvis a complex cystic mass likely representing the ectopic was seen in the right fallopian tube just beneath the ovary. This mass correlated with the location of the patients ectopic when laparascopy was performed. Remember you do not need to find the ectopic on ultrasound. As ED providers our goal is to identify an IUP. If we can’t, and the BHCG is positive, this is an ectopic until proven otherwise.



It's important to follow appropriate cleaning protocol when using the intracavitary probe at EUHM so the probe will be available for others. There are labels and biohazard bags in the cabinet with the probe. After you complete your exam remove the probe cover wipe off the probe and place it in a labeled biohazard bag in the dirty utility room. Let the charge nurse know that one of the techs will need to take the probe to radiology for processing.