Gynécologie-Obstétrique

Avortement et menace d'avortement

Same-day confirmation of intrauterine pregnancy failure in women with first- and early second-trimester bleeding. Fertil Steril. 2018 Jun;109(6):1060-1064. doi: 10.1016/j.fertnstert.2018.02.006.

Ectopique

Évaluation échographique des complications au premier trimestre de grossesse. Morin L, Cargill YM, Glanc P. J Obstet Gynaecol Can. 2016 Oct;38(10):989-996. doi: 10.1016/j.jogc.2016.06.002.

Organigramme caractérisation d'une grossesse intrautérine

Organigramme ectopique

Beta hCG Doubling Time Calculator (avec valeurs selon nombre semaines)

Diagnosis and management of ectopic pregnancy. Barash JH, Buchanan EM, Hillson C. Am Fam Physician. 2014 Jul 1;90(1):34-40. PMID: 25077500 Free Article

Organigramme

The discriminatory β-hCG level used at different institutions varies, although 1,500 to 2,000 mIU per mL (1,500 to 2,000 IU per L) is typical. It also depends on sonographer experience and patient characteristics, such as body habitus and the presence of significant abdominal bleeding or fibroids.14–16 In general, as the β-hCG level increases, the specificity of ultrasonography for detecting a viable intrauterine pregnancy also increases. Use of the β-hCG discriminatory level is not perfect, however, because cases of viable intrauterine pregnancy not detected by ultrasonography have been reported with β-hCG levels up to 4,300 mIU per mL (4,300 IU per L).

Diagnosis and treatment of ectopic pregnancy Heather Murray, Hanadi Baakdah, Trevor Bardell, Togas Tulandi CMAJ Oct 2005, 173 (8) 905-912; DOI: 10.1503/cmaj.050222

Although a single very low serum level (< 100 IU/L) has been felt to be reassuring, in a review of 716 admitted patients with ectopic pregnancy, 29% of those with such a level were found to have tubal rupture at laparoscopy. The risk of tubal rupture was similar across a wide range of β-hCG values.

Another study identified 38 instances of rupture among women with serum levels ranging from 10 to 189 720 IU/L.7 Thus, a single serum β-hCG measurement cannot exclude ectopic pregnancy or predict the risk of rupture unless it is less than 5 IU/L

Diagnosis and Management of Ectopic Pregnancy. Am Fam Physician. 2005 Nov 1;72(9):1707-1714

Pregnancy of unknown location, Tal Milman, Melissa Walker , Jackie Thomas, CMAJ September 28, 2020 192 (39) E1132; DOI: https://doi.org/10.1503/cmaj.200142

Pregnancy of unknown location, Gökhan Boyraz and Gürkan Bozdağ, J Turk Ger Gynecol Assoc. 2013; 14(2): 104–108. Published online 2013 Jun 1. doi: 10.5152/jtgga.2013.74317