Anembryonic pregnancy

Empty GS without fetal pole
(only 1 view of 3 needed for a MSD).
An empty GS witha MSD of ≥25 mm is
diagnostic for an anembryonic pregnancy.

Anembryonic pregnancy

Ectopic pregnancy

Note that this GS with fetal pole is not
intrauterine (no cervix is seen in
the same plane).

Free Fluid in Cul-de-Sac

Sagittal view of the uterus. Note the
presence of heterogeneous fluid in the
posterior cul-de-sac. This may be a
finding with ectopic pregnancy or
uterine perforation.

Gestational trophoblastic disease
(molar pregnancy)
Often has a swiss cheese or moth-eaten
appearance on ultrasound. Image of complete
mole (no embryo); partial moles usually present as
non-viable pregnancy on US. Precautions should
be taken due to increased risk for bleeding;
often refer for inpatient management > 12 weeks.
Send POC for pathology and obtain baseline serum hCG.
See Exercise 3.2.e for details.
molar pregnancy

Images AIUM Ultrasound Lecture Series 2013 and Reeves, M.