{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T14:22:14Z","timestamp":1747146134191,"version":"3.40.5"},"reference-count":8,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2023,2,27]],"date-time":"2023-02-27T00:00:00Z","timestamp":1677456000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Australas J Ultrason Med"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Early pregnancy ultrasound must satisfy objective criteria to make a safe diagnosis of miscarriage. The differential diagnosis of low\u2010lying gestational sac includes cervical stage of miscarriage and cervical and caesarean scar ectopic pregnancies. Misdiagnosis can lead to significant maternal morbidity. We describe a pregnancy in a 36\u2010year\u2010old primiparous woman where ultrasound findings of a low\u2010lying gestation sac satisfied criteria for miscarriage; however, dilatation and curettage of pregnancy contents resulted in brisk cervical bleeding. Ultrasound at 6\u2009weeks 6\u2009days of gestation showed an intra\u2010uterine pregnancy of uncertain viability. Repeat scan after 11\u2009days confirmed miscarriage based on an absence of interval progression between scans and no embryonic heartbeat. The collapsed gestational sac (GS) was seen at the level of the internal os with decidual reaction and peri\u2010trophoblastic blood flow. Inferior to the sac, minimally vascular trophoblastic appearing tissue was beginning to distend the upper cervical canal: the sliding sign was positive for the GS and negative for the upper cervical contents. Cervical stroma was clearly seen circumferential to the distending tissue. The patient underwent dilatation and curettage of the uterus complicated by 2000 ml haemorrhage requiring blood transfusion and medical and surgical management with intra\u2010cavitary placement of a Foley catheter. Histopathology confirmed pregnancy tissue with the disruption of cervical epithelium but no true invasion. The patient was counselled to attend a specialist obstetric imaging facility for an early dating ultrasound in future pregnancies. The current body of literature does not describe cases of low\u2010lying gestation sac miscarriage with high\u2010risk features of trophoblastic extension into the cervical canal. We suggest maintaining a high index of suspicion and excluding differential diagnoses as the majority of women have no risk factors for ectopic pregnancy. These cases should be recommended for surgical management.<\/jats:p>","DOI":"10.1002\/ajum.12337","type":"journal-article","created":{"date-parts":[[2023,2,28]],"date-time":"2023-02-28T06:35:40Z","timestamp":1677566140000},"page":"199-202","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Overlapping imaging features between miscarriage of a low\u2010lying gestational sac and cervical ectopic pregnancy"],"prefix":"10.1002","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2633-7026","authenticated-orcid":false,"given":"Jessica","family":"Teoh","sequence":"first","affiliation":[{"name":"Women and Babies Department Royal Prince Alfred Hospital  Camperdown New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sumathi","family":"Rajendran","sequence":"additional","affiliation":[{"name":"Women and Babies Department Royal Prince Alfred Hospital  Camperdown New South Wales Australia"},{"name":"Sydney Ultrasound for Women  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarika","family":"Gupta","sequence":"additional","affiliation":[{"name":"Women and Babies Department Royal Prince Alfred Hospital  Camperdown New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,2,27]]},"reference":[{"doi-asserted-by":"publisher","key":"e_1_2_11_2_1","DOI":"10.1136\/bmj.h4579"},{"doi-asserted-by":"publisher","key":"e_1_2_11_3_1","DOI":"10.15406\/ogij.2020.11.00496"},{"doi-asserted-by":"publisher","key":"e_1_2_11_4_1","DOI":"10.1046\/j.1469-0705.2002.00559.x"},{"doi-asserted-by":"publisher","key":"e_1_2_11_5_1","DOI":"10.1111\/1471-0528.14189"},{"doi-asserted-by":"publisher","key":"e_1_2_11_6_1","DOI":"10.1016\/j.tjog.2013.10.009"},{"doi-asserted-by":"publisher","key":"e_1_2_11_7_1","DOI":"10.1186\/s40738-015-0008-z"},{"doi-asserted-by":"publisher","key":"e_1_2_11_8_1","DOI":"10.1258\/ult.2012.012023"},{"doi-asserted-by":"publisher","key":"e_1_2_11_9_1","DOI":"10.1097\/01.AOG.0000533222.29391.0a"}],"container-title":["Australasian Journal of Ultrasound in Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ajum.12337","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ajum.12337","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ajum.12337","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,11]],"date-time":"2023-09-11T04:56:53Z","timestamp":1694408213000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ajum.12337"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,2,27]]},"references-count":8,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2023,8]]}},"alternative-id":["10.1002\/ajum.12337"],"URL":"https:\/\/doi.org\/10.1002\/ajum.12337","archive":["Portico"],"relation":{},"ISSN":["1836-6864","2205-0140"],"issn-type":[{"type":"print","value":"1836-6864"},{"type":"electronic","value":"2205-0140"}],"subject":[],"published":{"date-parts":[[2023,2,27]]},"assertion":[{"value":"2023-02-27","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}