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To convert values for progesterone to nanomoles per liter, multiply by 3.18. Although the pros and cons of the medical management of ectopic pregnancy with methotrexate are beyond the scope of this chapter, two points are worth making.
First, LMP dating is off by at least 1 week 15% of the time.
The reader is referred to the American Institute of Ultrasound In Medicine for its extensive publications, workshops, and meetings (American Institute of Ultrasound In Medicine, 14570 Sweitzer Lane, Suite 100, Laurel, MD 20707–5906).
described the orderly appearance of gestational sac, yolk sac, and embryo with heartbeat at a given number of days from the onset of the last menstrual period (Table 1).
For patients who are not at high risk for ectopic pregnancy, the two most common presenting symptoms are bleeding and pelvic pain. In a 1981 study, Kadar and associates found that a “discriminatory” β-h CG value of 6000 m IU/ml could be used as a cutoff for when an intrauterine gestational sac should be be seen via TAS.In fact, certification of residency programs requires documentation of adequate exposure to and training in the evaluation of first-trimester ultrasound.Failure to understand the limitations of diagnostic ultrasound or inadequate training of physicians in this technique can result in grave complications for the patient and liability for health-care providers.Normal early gestational sacs are seen eccentrically placed, adjacent to the echogenic central stripe (Fig. These masses usually resolve spontaneously by the onset of the second trimester.
They can contain areas of complex echogenicity that may masquerade as a neoplasm or an ectopic pregnancy.The literature regarding the correlation between quantitative β-h CG titers and early intrauterine gestational sacs and embryonic structures has been made somewhat confusing by the array of reference standards used to quantify β-h CG.