P23.07: Ultrasound markers prior to 8 weeks' gestational age for the prediction of fetal demise prior to 12 weeks' gestation

Abstract

Poster discussion hub abstracts of acute abdomen, serum human chorionic gonadotropin (hCG) < 5000 IU/L, absence of fetal cardiac activity on TVS and absence of significant hemoperitoneum, defined as blood above the level of the uterine fundus and/or in Morison's pouch. Those women with severe lower abdominal pain, hemodynamic instability or significant blood in the abopelvis defined as blood above level of uterine fundus or positive blood in Morison's Pouch were excluded from the study. The correlation with type and success of management were investigated. Results: 5880 consecutive women presented to the EPU.287 (4.8%) women diagnosed with EP.246 had tubal EP. Hemoperitoneum was seen in 143/246 (58%) of cases. Significant hemoperitoneum was noted in 84/143 (59%) these cases were managed surgically and therefore excluded from the study. Of the remaining 59/143 (41%) with non-significant hemoperitoneum, 29/59 (49%) had surgery for clinical indications, 30/59 (51%) had non-surgical management. For these 30 cases mean hCG level at 0h was 1487.8±1654.7 IU/L and at 48 h 1270.7±1745. 1IU/Lumen Hemoglobin at presentation was 11.0±1.2 g/dL. 15/30 received methotrexate (MTX) (6/15 had successful management and 9/15 had failed medical management and treated surgically. 15/30 were managed expectantly (12/15 were successful, 1/15 had surgery and 2/15 had MTX). In total, 18/30 (60%) women with non-significant hemoperitoneum had successful management. Conclusions: This study suggests that the finding of hemoperitoneum on ultrasound examination may not be an absolute contraindication to conservative management of tubal EP. P23.07 Ultrasound markers prior to 8 weeks' gestational age for the prediction of fetal demise prior to 12 weeks' gestation