Second, methotrexate therapy for proven ectopic pregnancies appears to work best if the ectopic adnexal mass is less than 4 cm and the β-h CG titer less than 5000 m IU/ml.
Pregnancies that do not meet these criteria are more likely either to require multiple doses of methotrexate or to be unresponsive to treatment.
The reader is referred to the American Institute of Ultrasound In Medicine for its extensive publications, workshops, and meetings (American Institute of Ultrasound In Medicine, 14570 Sweitzer Lane, Suite 100, Laurel, MD 20707–5906).
described the orderly appearance of gestational sac, yolk sac, and embryo with heartbeat at a given number of days from the onset of the last menstrual period (Table 1).
Particularly with the rise of patients undergoing assisted reproduction, this entity is being encountered more frequently.
Today's obstetrician gynecologist is frequently called upon to interpret and in many cases perform ultrasound scans in the first trimester.
In fact, certification of residency programs requires documentation of adequate exposure to and training in the evaluation of first-trimester ultrasound.
Failure to understand the limitations of diagnostic ultrasound or inadequate training of physicians in this technique can result in grave complications for the patient and liability for health-care providers.
With TVS, an early gestational sac should be seen at a β-h CG level of 1500 to 2000 m IU/ml (Third International Standard).
For patients with lower titers, the β-h CG should double within 48 hours.5), and large subchorionic bleeds have all been associated with an increased risk of first-trimester pregnancy loss.