abnormal

First Trimester Bleeding: Vaginal bleeding in early pregnancy, often caused by subchorionic hemorrhage. May result in normal pregnancy or miscarriage.

Subchorionic Hemorrhage: Bleeding between the myometrium and the margins of the gestational sac. Appears echogenic initially and becomes anechoic over time.

Blighted Ovum (Anembryonic Pregnancy): A fertilized ovum implants but does not grow into an embryo, resulting in an empty gestational sac.

• Sonographic Findings:

  • MSD ≥ 25 mm with no embryo.

  • Poor decidual reaction (<2 mm thickness).

  • Irregular gestational sac shape.

Miscarriage: Spontaneous loss of pregnancy before 20 weeks, commonly caused by chromosomal abnormalities (aneuploidy).

• Symptoms: Vaginal bleeding, cramping, passage of tissue.

Threatened Miscarriage: Vaginal bleeding in pregnancy with a closed cervix and live intrauterine pregnancy. Often associated with subchorionic hemorrhage.

Inevitable Miscarriage: Open internal cervical os with bleeding; the gestational sac is low in the uterus and may migrate downward.

Incomplete Miscarriage: Expulsion of some, but not all, pregnancy tissue from the uterus.

• Sonographic Findings: Retained products with mixed echogenicity and potential vascular supply.

Complete Miscarriage: All pregnancy tissue is expelled. The uterus appears empty on ultrasound with a single endometrial stripe.

Missed Miscarriage: A non-developing embryo or fetus remains in the uterus without symptoms like bleeding or cramping.

• Sonographic Findings:

  • CRL ≥ 7 mm with no fetal cardiac activity.

  • MSD ≥ 25 mm with no yolk sac or embryo.

Ectopic Pregnancy: Implantation of the blastocyst outside the uterine cavity (most commonly in the Fallopian tube).

• Symptoms: Amenorrhea, abdominal pain, vaginal bleeding.

• Sonographic Findings:

  • Empty uterus with a thickened endometrium.

  • Pseudo gestational sac.

  • Adnexal mass ("bagel sign").

  • Free fluid in the posterior cul-de-sac.

  • Ring of fire on color Doppler.

Cornual Ectopic Pregnancy: Ectopic pregnancy in the interstitial portion of the Fallopian tube near the uterine cornua; high risk of hemorrhage.

Cervical Ectopic Pregnancy: Gestational sac implanted in the cervix, detectable via ultrasound.

Ovarian Ectopic Pregnancy: Gestational sac implanted within the ovary.

Abdominal Ectopic Pregnancy: Pregnancy located in the abdominal cavity, independent of the uterus.

Ruptured Ectopic Pregnancy: Severe complication involving rupture of an ectopic pregnancy, causing internal bleeding and requiring immediate medical intervention.

Gestational Trophoblastic Disease (GTD): A spectrum of abnormal trophoblastic proliferation resulting from abnormal conception.

• Forms: Hydatidiform mole, invasive mole, and choriocarcinoma.

• Symptoms: Painless vaginal bleeding, elevated B-HCG (>100,000 UI/ml), hyperemesis gravidarum.

Hydatidiform Mole: Abnormal growth of cysts in the placenta with no evidence of fetal development.

• Sonographic Findings: "Bunch of grapes" or "snowstorm" appearance.

Partial Mole: A form of hydatidiform mole caused by fertilization of one ovum by two sperm, often with some fetal development.

Coexistent Mole: Rare twin pregnancy where one twin is a hydatidiform mole, and the other is a live fetus.

Invasive Mole (Chorioadenoma Destruens): A locally invasive form of hydatidiform mole that penetrates the myometrium but does not metastasize.

Choriocarcinoma: Malignant form of GTD with rapid myometrial invasion and potential metastasis to organs like the lungs, brain, and kidneys.

• Symptoms: Vaginal bleeding, abdominal pain, dyspnea, and neurologic issues.

Theca Lutein Cysts: Functional ovarian cysts associated with molar pregnancies, often bilateral and large, with a multilocular cystic appearance.

Embryonic Oligohydramnios: A gestational sac that is only 5 mm greater than the CRL, indicating possible embryonic demise.

Embryonic Growth Restriction: Slower-than-expected embryonic or gestational sac growth, potentially due to chromosomal abnormalities like triploidy.