Talk on obstetric emergencies dr.pradeep
- 1. IMAGING IN OBSTETRIC EMERGENCIES BY DR.S.PRADEEP.MD,DNB,RD. CONSULTANT RADIOLOGIST FORTIS HOSPITAL. BANGALORE
- 2. ECTOPIC PREGNANCY SUBCHORIONIC HEMATOMA PLACENTAL ABRUPTION VASA PREVIA SUCCENTURIATE PLACENTA UTERINE RUPTURE FIBROID DEGENERATION CERVICAL INCOMPETENCE
- 6. RIGHT THING IN THE WRONG PLACE
- 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 ā¢ URINE PREGNANCY TEST(ELISA) ā¢ SERUM BETA HCG- - EXTREMELY RELIABLE - (POSITIVE WITHIN 7 DAYS OF CONCEPTION) ā¢ LEVELS <10mIU/L MAY NOT BE DETECTED(FALSE NEGATIVE TEST)
- 11. LIMITATION OF PREGNANCY TESTS CANNOT DIFFERENTIATE ā¢ ECTOPIC GESTATION ā¢ INRAUTERINE NORMAL/ABNORMAL GESTATION ā¢ SPONTANEOUS ABORTION
- 12. SONOGRAPHY MAY SHOW ā¢ TRUE INRAUTERINE GETATIONAL SAC - DOUBLE DECIDUAL SAC SIGN -YOLK SAC(10 MM GEST.SAC) -FOETAL POLE(16MM GEST.SAC) -CARDIAC ACTIVITY(CRL-5 MM ) ā¢ THIS RULES OUT AN ECTOPIC AS HETEROTOPIC PREGNANCY IS RARE
- 14. EVOLUTION OF NORMAL IU PREGNANCY 0 10 0 1st Qtr 4th Qtr E as W es N or
- 15. DOUBLE DECIDUAL SAC SIGN
- 16. TRUE IU GESTATIONAL SAC
- 17. NEGATIVE TVS ā¢ NO IU GESTATIONAL SAC ā¢ NO ADNEXAL ABNORMALITY POSSIBLITIES ARE ā¢ EARLY SPONTANEOUS ABORTION ā¢ EARLY IU NORMAL/ABNORMAL GESTATION ā¢ ECTOPIC GESTATION
- 18. BETA HCG ā¢ IU GESTATIONAL SAC SHOLD BE SEEN ON TVS WITH A BETA HCG OF 1000mIU/L ā¢ IF NOT THE POSSIBILITY OF AN ECTOPIC IS VERY LIKELY
- 19. BETA HCG ā¢ TIME Miu/l ā¢ 1 week 0-50 ā¢ 2 week 20-500 ā¢ 3 week 500-5000 ā¢ 4 week 3000-19000 ā¢ 8 week 14000-16000 ā¢ 12 week 16000-160000
- 21. SERIAL BETA HCG AT 48 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 ā¢ IU DDSS/FOETAL POLE ā¢ BLIGHTED OVUM/MOLAR PREG ā¢ ADNEXAL MASS/FREE FLUID-ECTOPIC ā¢ NO ABNORMAL FINDINGS-HIGHLY SUSPICIOUS FOR AN ECTOPIC-LAPROSCOPY
- 23. TVS FINDINGS IN ECTOPIC GESTATION ā¢ PSEUDO INTRAUTERINE SAC ā¢ ADNEXAL SAC ā¢ ADNEXAL SAC WITH YOLK SAC ā¢ ADNEXAL SAC WITH FOETAL POLE ā¢ ADNEXAL NODULE ā¢ ADNEXAL MASS ā¢ ADNEXAL MASS WITH TURBID FLUID
- 24. PSEUDOGESTATIONAL SAC 10% 0F ECTOPICS
- 26. T2 WI OF ECTOPIC SAC
- 27. ECTOPIC SAC WITHOUT YS
- 28. ECTOPIC SAC WITH YOLK SAC
- 29. INCREASE IN SIZE OF ECTOPIC TWO DAYS LATER
- 30. POST MTP ECTOPIC
- 31. FOURTH ECTOPIC
- 32. DEAD EMBRYO IN ECTOPIC SAC
- 33. POST MTP CHRONIC DEAD ECTOPIC
- 34. POST MTP LIVE ECTOPIC
- 35. CARDIAC ACTIVITY IN LIVE ECTOPIC
- 36. INVITRO SCAN OF UNRUPTURED SAC MILKED OUT FROM TUBE
- 37. TUBAL HEMATOCELE
- 40. TUBAL HEMATOCELE
- 42. T2WI OF TUBAL HEMATOCELE
- 43. RUPTURED TUBE
- 44. RUPTURED TUBE
- 45. ECTOPIC WITH PERI TUBAL HEMOPERITONEUM
- 47. RUPTURED ECTOPIC
- 50. TUBAL ABORTION
- 52. T2WI IN RT CORNUAL ECTOPIC
- 53. OVARIAN ECTOPIC
- 57. 1 st PREG RUPTURED ECTOPIC- HEMOPERITONEUM
- 59. 2 nd-ECTOPIC MANAGED WITH METHOTREXATE
- 60. CORPUS LUTEAL CYST MIMIKING ECTOPIC
- 61. DD
- 63. RT OVARIAN CORPUS HEMORRHAGICUM WHERE IS THE ECTOPIC?
- 64. TVS NEXT DAY SHOWED THE ECTOPIC
- 66. ONE DAY LATER THE ECTOPIC WAS FOUND
- 67. LOOK AT THE DIFFERENCE BETWEEN ECTOPIC AND CORPUS LUTEAL CYST
- 69. WHAT IS IT ?
- 70. DEVELOP A SONIC EYE
- 74. PLACENTAL ABRUPTION AND RETROPLACENTAL HEMATOMA
- 76. VASA PREVIA- VELAMENTOUS INSERTION OF CORD
- 77. TYPES OF VASA PREVIA
- 78. COMPLICATIONS OF VASA PREVIA
- 79. CORD VESSELS CLOSELY APPOSED TO THE CERVICAL INNER OS
- 81. SUCCENTURIATE PLACENTA WITH BRIDGING VESSELS
- 82. BILOBATE PLACENTA WITH CORD INSERTION INBETWEEN
- 83. MRI IN VASA PREVIA
- 85. UTERINE RUPTURE
- 89. THANK YOU DR S PRADEEP.