0:00

The vast majority of the information

0:02

that I will be presenting here today actually comes from

0:06

this consensus statement,

0:07

which was called the diagnostic criteria

0:10

for non-viable pregnancy early in the first trimester.

0:14

And this was put out in the New England Journal

0:16

in Me of Medicine.

0:17

And I still call these the new guidelines even though

0:20

they're about 10 years old now.

0:22

But I still see people kind of struggling with these

0:25

and not naming things properly.

0:27

But not only will we be going over this,

0:29

but we'll also be giving a little bit of historical context

0:32

of how these guidelines

0:34

of assessing first trimester ultrasound have

0:37

evolved over time.

0:41

The other article that will really, um,

0:44

help us was published in the British Medical Journal,

0:48

and it was by the same group that actually did the big study

0:52

that kind of formed the foundation

0:54

of the consensus statement.

0:56

But their follow-up paper did help

0:59

to streamline things a little bit more.

1:00

So we'll be covering those as well.

1:03

And then before we move on, I just wanna give you a case

1:08

to think about in the context, uh,

1:10

as we go through this lecture.

1:13

And so this is a typical, you know, ubiquitous history

1:16

that comes from the ER patient presents with pain

1:19

and bleeding and their pregnancy test is positive.

1:23

We have a pretty good idea of what that means.

1:25

But, you know, we used to term this rule out topic

1:27

or rule out fetal demise,

1:30

and I want you to think about the possible answers to

1:34

how you would interpret this.

1:36

Either this is a normal intru in pregnancy, is this

1:40

diagnostic of early pregnancy failure,

1:43

could it be a pseudo gestational sac or suspicious ectopic,

1:48

or do we need to know the quantitative vta h CG

1:52

before I can either answer this or is it none of these?

1:56

So this is gonna frame our discussion

1:59

and, uh, we'll get into the topics right now.