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Subchorionic Hemorrhage Appearing as Twin Gestation on Endovaginal Ultrasound

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Author(s): Kahn, Andy | Kahn, Amy L | Fox, J Christian | Langdorf, Mark

Journal: Western Journal of Emergency Medicine
ISSN 1936-900X

Volume: 9;
Issue: 2;
Start page: 115;
Date: 2008;
Original page

Keywords: subchorionic hemorrhage | ultrasound | vaginal bleeding | bedside ultrasound | endovaginal ultrasound

ABSTRACT
This case study describes a pregnant patient with vaginal bleeding who had a bedside endovaginal ultrasound in the emergency department (ED). The emergency physician identified a live intra-uterine pregnancy (IUP) with another structure that appeared to be a second gestational sac. The patient subsequently had an endovaginal ultrasound in the radiology department 46 minutes later. The attending radiologist described one live IUP and a subchorionic hemorrhage. Comparison of the ED and radiology ultrasound showed that the second structure, identified as a subchorionic hemorrhage, had significantly decreased in size. Endovaginal ultrasound in the evaluation of possible ectopic pregnancy is a useful bedside tool in the ED. We discuss a pitfall that can occur with endocavitary ultrasound when a twin gestation is presumed.
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