Pelvic Ultrasonography

Robert F. Reardon Dietrich V. K. Jehle

Imaging, Techniques

Sonographic,, PeiyicAnatomy Transabdominal, ,y,e„r,s„u,s „T1rans,vaginal,,!mag|ng Uterus

Oyaries

Normal. Early, Pregnancy Ultrasound,, Findings

Pregniancy,Je,st!ng Determining, Gestational, Age

Ectopic,Pregnancy EctopicXocation

Initial EyaIua.ti.onof,Patients,,at,Risk, ,,fo,r„,E.P Ultrasound,, ,Evaluation

Quantitatiye,, Serum,, bh.C.G, „and,Discriminatory,Zone Po.tentiaiEiro.rsin,, the„,Diagno,sis, „o,f,,EP HeterotopicPregnancy

Ectopic,Rregnancy„with„Low, „Serum, ,b,h,C,G Abnormal,, First-Trimester, Intrauterine, Pregnancy

Spontaneous, Abortion

Threatened, Abortion

Viability,, of„an„,Early, ,IUP Subc,h,o,ri„onic, „Hematoma yaginal Ble1eding„with„,N,o„, IUP MolalPregnancy

Second-, ,and„Jhird,:TIime,Ste,r„Pregnlancy Immediate, „FetaLyiabiliSv Oligohydramnios, and „Polyhy.d.ram.nios Umbili,cal,,Cord FetalGender

Fle,tal„,St,r,u,ctu„r,e,s„,a,n,d,, Abnormalities ThiId-Jri.mesterB!eeding—Pi,acenta„PIeyia Ultrasound,,, Exam,, ,fo,r, , S,u,s,pected„,Place,n,ia„ PMreyia

False-Positiye,, ,Diagn,o,sis„,o,f, Placenta, Preyia

Third „Tr|meste.r„B|eeding—P|acenta! Abruption

RetroplacentaiHematoma

M,arginal,H,em.atoma

Trauma„in, Pregnan.cv Fetal„Spnpgraphic, Eyaluation

Ceryix. „andyagina

Adnexal, „Masses

Complex Adnexal Masses

Other,, Conditions

Pelyic Infla.m.matoryD.iseas.e, and „Tubooya.rianAbsc.ess oyarian„Jprsipn Chapter,, References

Ultrasonography is a standard diagnostic tool used in the evaluation of pregnancy and female pelvic pathology. 1 Bedside pelvic ultrasound is commonly used in the emergency department (ED) in order to guide the evaluation of women with pelvic pain, pregnancy problems, and maternal trauma. The use of early pelvic ultrasound is essential for the timely diagnosis of ectopic pregnancy and placenta previa. Recent studies have demonstrated that bedside transvaginal ultrasound performed by emergency physicians improves early detection and decreases morbidity of patients with ectopic pregnancy. 23 and 4 The availability of bedside pelvic sonography decreases the ED length of stay for women with early pregnancy.5 This chapter describes many other indications for ED bedside pelvic sonography, all of which may be useful to the practicing emergency physician. Since training and experience with pelvic sonography is highly variable among emergency physicians, a cautious approach to "ruling out" serious conditions should be employed initially. For example, ordering a "formal" ultrasound to be performed in the radiology or ob/gyn department is reasonable when no intrauterine pregnancy is identified in a symptomatic pregnant patient.

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