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A G O'Neil

Publications and source records attributed to A G O'Neil.

6 recordsLinked to original sources

Problems in the diagnosis of ectopic pregnancy: the pseudogestational sac.

The term pseudogestational sac was first suggested by Mueller in 1979. It was applied to the echo pattern which he noted on ultrasonic examination of 2 patients with ectopic pregnancy. He suggested that the echo pattern, which can easily be misinterpreted as a gestational sac, is produced by the decidual cast with blood contained in its centre. During the past 3 years, 6 cases of pseudogestational sacs have been recorded at K.E.M.H. In 3 of these the possibility of ectopic pregnancy was suggested by the ultrasonologist because of suspicious extra-uterine echo patterns associated with the pseudogestational sac. In the remaining 3 patients the ultrasonologist reported that there was an intrauterine pregnancy, an error which influenced clinical management. These 3 cases are summarized below.

Adult↗

Problems in the diagnosis of ectopic pregnancy.

Problems in the diagnosis of ectopic pregnancy have been assessed over a 4-month period at King Edward Memorial Hospital. Twenty-three of thirty women (77%) were sent home after their initial presentation with symptoms of their ectopic pregnancy. Thirteen were sent home from major teaching hospitals and the remaining 10 by their general practitioners. In 76 patients, laparoscopy was performed to exclude ectopic pregnancy; the diagnosis was confirmed in only 30. Plasma beta HCG values were elevated in all patients with an ectopic pregnancy within the Fallopian tube. The finding of a beta HCG value of less than 2.5 i.u./l could have allowed 36 of these patients to avoid diagnostic laparoscopy. Nine patients with intrauterine pregnancies (5 continuing and 4 aborting) might have avoided laparoscopy if ultrasonography had been used. Careful application of these tests, together with good history taking, will minimise the number of patients in whom an incorrect diagnosis is made.

Chorionic Gonadotropin↗