A woman with suspected ectopic pregnancy has an ultrasound showing a small fluid collection inside the uterine cavity. Which feature favours a pseudogestational sac over a true early gestational sac?

• A Eccentric location within the myometrium-bordered cavity
• B Presence of the intradecidual sign
• C Double decidual sac sign
• D Absence of a yolk sac or fetal pole with contents returning internal echoes ✓

Explanation

A pseudogestational sac is a blood or fluid collection within the uterine cavity that lacks a yolk sac and fetal pole, often contains internal echoes, and has irregular tapering borders. True sacs show the intradecidual and double decidual sac signs, lie eccentrically, and are anechoic. Recognising the pseudosac prevents the false reassurance of an apparent intrauterine pregnancy in a patient who actually has an ectopic.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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