Right Adnexa, + ?-HCG
Representative image of Uterus

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Tubal Ectopic Pregnancy

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  • Coronal transvaginal view of the right adnexa demonstrates an extauterine gestational sac (arrows) containing an embryo (calipers)
  • Uterine cavity is empty



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  • Left-An intrauterine gestational sac is surrounded by two echogenic rings, an inner ring (short arrows),and an outer ring (long arrows), corresponding to two layers of decidua ("double decidua sign")
  • Right sagittal transabdominal view of another patient demonstrates a fluid collection (arrows) in the uterus, with none of the characteristics of a gestational sac (no yolk sac or embryo within it, no double echogenic ring surrounding it). Such a fluid collection, representing blood or secretions in the uterine cavity in a patient with an ectopic pregnancy, has been termed a pseudogestational sac


Heterotopic Pregnancy
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Transverse (TRN RT) view through the uterus and right adnexa demonstrates two gestational sacs, one within the uterus (short arrow) and one ectopicallly located in the right adnexa (long arrow)

Heterotopic pregnancy is rare: ~ 1:5,000 incidence [* though increasing incidence due to Rx with fertility drugs]

Characteristic of Ectopics
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  • Left: Transvaginal view through the right adnexa with color Doppler demonstrates a soft tissue mass (arrows) surrounded by considerable blood flow ("ring of fire" sign)
  • Right: Sagittal image demonstrate moderate cul-de-sac fluid with no evidence of an intrauterine pregnancy
These signals are relayed buying clomid online safe which then is by a number of such as medial preoptic and paraventricular nulcei.