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Talk on obstetric emergencies dr.pradeep
- 1. IMAGING IN OBSTETRIC EMERGENCIES BY DR.S.PRADEEP.MD,DNB,RD. CONSULTANTRADIOLOGIST FORTIS HOSPITAL. BANGALORE
- 2. ECTOPIC PREGNANCY SUBCHORIONIC HEMATOMA PLACENTALABRUPTION VASA PREVIA SUCCENTURIATE PLACENTA UTERINE RUPTURE FIBROID DEGENERATION CERVICAL INCOMPETENCE
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- 8. LOCATION INTRAUTERINE EXTRAUTERINE CORNUAL TUBAL-95% INTERSTITIAL-2.5%OVARIAN-0.5% CERVICAL-0.1% ABDOMINAL -.1% HETEROTOPIC PREGNANCY 1 IN 3 00 000 (HIGHER IN IVF PREG)
- 10. PREGNANCT TESTING • URINEPREGNANCY TEST(ELISA) • SERUM BETA HCG- - EXTREMELY RELIABLE - (POSITIVE WITHIN 7 DAYS OF CONCEPTION) • LEVELS <10mIU/L MAY NOT BE DETECTED(FALSE NEGATIVE TEST)
- 11. LIMITATION OF PREGNANCY TESTS CANNOTDIFFERENTIATE • ECTOPIC GESTATION • INRAUTERINE NORMAL/ABNORMAL GESTATION • SPONTANEOUS ABORTION
- 12. SONOGRAPHY MAY SHOW •TRUE INRAUTERINE GETATIONAL SAC - DOUBLE DECIDUAL SAC SIGN -YOLK SAC(10 MM GEST.SAC) -FOETAL POLE(16MM GEST.SAC) -CARDIAC ACTIVITY(CRL-5 MM ) • THIS RULES OUT AN ECTOPIC AS HETEROTOPIC PREGNANCY IS RARE
- 14. EVOLUTION OF NORMALIU PREGNANCY 0 10 0 1st Qtr 4th Qtr E as W es N or
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- 17. NEGATIVE TVS • NOIU GESTATIONAL SAC • NO ADNEXAL ABNORMALITY POSSIBLITIES ARE • EARLY SPONTANEOUS ABORTION • EARLY IU NORMAL/ABNORMAL GESTATION • ECTOPIC GESTATION
- 18. BETA HCG • IUGESTATIONAL SAC SHOLD BE SEEN ON TVS WITH A BETA HCG OF 1000mIU/L • IF NOT THE POSSIBILITY OF AN ECTOPIC IS VERY LIKELY
- 19. BETA HCG • TIMEMiu/l • 1 week 0-50 • 2 week 20-500 • 3 week 500-5000 • 4 week 3000-19000 • 8 week 14000-16000 • 12 week 16000-160000
- 21. SERIAL BETA HCG AT48 HRS VALUE DECREASES - SPONTANEOUS ABORTION VALUE DOUBLES - IN 85% OF NORMAL IU GEST(4-6 WKS) - IN 13% OF ECTOPICS VALUE INCREASES SUBNORMALLY(<66%) - IN 80% OF ECTOPIC GESTATION - IN 15% OF IU GEST VALUE INCRESES OR DECREASES - ABNORMAL IU GESTATION (MOLE / BLIGHTED OVUM)
- 22. REPEAT TVS • IUDDSS/FOETAL POLE • BLIGHTED OVUM/MOLAR PREG • ADNEXAL MASS/FREE FLUID-ECTOPIC • NO ABNORMAL FINDINGS-HIGHLY SUSPICIOUS FOR AN ECTOPIC-LAPROSCOPY
- 23. TVS FINDINGS INECTOPIC GESTATION • PSEUDO INTRAUTERINE SAC • ADNEXAL SAC • ADNEXAL SAC WITH YOLK SAC • ADNEXAL SAC WITH FOETAL POLE • ADNEXAL NODULE • ADNEXAL MASS • ADNEXAL MASS WITH TURBID FLUID
- 24. PSEUDOGESTATIONAL SAC 10% 0FECTOPICS
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- 26. T2 WI OFECTOPIC SAC
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- 28. ECTOPIC SAC WITHYOLK SAC
- 29. INCREASE IN SIZEOF ECTOPIC TWO DAYS LATER
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- 32. DEAD EMBRYO INECTOPIC SAC
- 33. POST MTP CHRONICDEAD ECTOPIC
- 34. POST MTP LIVEECTOPIC
- 35. CARDIAC ACTIVITY IN LIVEECTOPIC
- 36. INVITRO SCAN OF UNRUPTUREDSAC MILKED OUT FROM TUBE
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- 42. T2WI OF TUBALHEMATOCELE
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- 45. ECTOPIC WITH PERITUBAL HEMOPERITONEUM
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- 52. T2WI IN RTCORNUAL ECTOPIC
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- 57. 1 st PREGRUPTURED ECTOPIC- HEMOPERITONEUM
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- 59. 2 nd-ECTOPIC MANAGEDWITH METHOTREXATE
- 60. CORPUS LUTEAL CYST MIMIKINGECTOPIC
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- 63. RT OVARIAN CORPUS HEMORRHAGICUM WHEREIS THE ECTOPIC?
- 64. TVS NEXT DAYSHOWED THE ECTOPIC
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- 66. ONE DAY LATERTHE ECTOPIC WAS FOUND
- 67. LOOK AT THEDIFFERENCE BETWEEN ECTOPIC AND CORPUS LUTEAL CYST
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- 77. TYPES OF VASAPREVIA
- 78. COMPLICATIONS OF VASAPREVIA
- 79. CORD VESSELS CLOSELYAPPOSED TO THE CERVICAL INNER OS
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- 82. BILOBATE PLACENTA WITHCORD INSERTION INBETWEEN
- 83. MRI IN VASAPREVIA
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- 89. THANK YOU DR SPRADEEP.