DIAGNOSIS EARLY PREGNANCY COMPLICATIONS

3 CONDITIONS IMPORTANT

1)ABORTION

2)ECTOPIC PREGNANCY

3)PREGNANCY OF UNKNOWN LOCATION

1)Clinical judgement

2)USG(TVS)

3)B-HCG estimation

USG errors common when hcg level<1500 miu/ml

In busy practice error of TVS is 1%.

HCG estimation -single value not diagnostic of pregnancy viabiity & pregnancy location.

PREMATURE SURVEILLANCE

All diagnostic test false positive & false negative

Too many survellence-diagnostic error increases

Too early surveillance-harmful intervention increases

No early USG in asymptomatic woman should be done-best time for USG 49 days amenorrhoea for asyptomatic female.

When Gestational age is known in ART & case is asymptomatic no USG is done before 5w5D & no HCG estimation is required every 2 days.

CRITERION  FOR DIAGNOSIS OF MISSED ABORTION

Embryo will appear between 8-16 mm of gestational sac as linear echogenic structure between yolk sac & gestational sac..

Normal gestational sac growth is 1 mm per day.

Anembryonic  Pregnancy—Gestational sac larger than 18 mm without yolksac or embryo.

MISSED ABORTION

Empty sac of 20 mm or more

Embryo Node 6 mm or more without cardiac activity.

Gestational sac >=25 mm withhout yolk sac