The role of ultrasonography in the diagnosis and management of early pregnancy complications

Key content The diagnosis of miscarriage and management of pregnancy of uncertain viability. Ultrasound features that increase the suspicion of pregnancy failure. Ultrasound features of both tubal and non‐tubal ectopic pregnancy. Pregnancy of unknown location: how to stratify risk using serum biochemistry and prediction models. Learning objectives To understand the role of ultrasonography as a diagnostic tool in early pregnancy and what should be expected of it. To highlight the importance of safety and caution when using ultrasound in early pregnancy. To understand the management options for a pregnancy of unknown location. To clearly understand the criteria that must apply before a diagnosis of miscarriage can be made. To know the ultrasound features of ectopic pregnancy and be aware of the risks of methotrexate treatment in the event of misdiagnosis. Ethical issues Misdiagnosis of miscarriage. Inappropriate use of methotrexate for treatment of presumed ectopic pregnancy. Maintaining patient choice in relation to the management of miscarriage and ectopic pregnancy.