{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T15:03:53Z","timestamp":1792681433962,"version":"4.5.0"},"reference-count":10,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2008,6,28]],"date-time":"2008-06-28T00:00:00Z","timestamp":1214611200000},"content-version":"vor","delay-in-days":332,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Academic Emergency Medicine"],"published-print":{"date-parts":[[2007,8]]},"abstract":"<jats:p> <jats:bold>Background<\/jats:bold>Ectopic pregnancies are frequently present in women who present to the emergency department with pregnancy and abdominal pain or bleeding, a subset of whom may require operative intervention.<\/jats:p><jats:p> <jats:bold>Objectives<\/jats:bold>To prospectively determine if emergency physician (EP)\u2010performed transabdominal pelvic ultrasonography (US) with determination of free abdominal fluid in the hepatorenal space predicted the need for operative intervention.<\/jats:p><jats:p> <jats:bold>Methods<\/jats:bold>Patients who were suspected to have an ectopic pregnancy were prospectively enrolled over a\u00a0ten\u2010month period. An EP\u2010performed bedside transabdominal pelvic US that included a view of the hepatorenal space (Morison's pouch) for free fluid. The EP US was classified as intrauterine pregnancy (IUP) or no definitive IUP, with Morison's pouch classified as positive or negative. The majority of patients had a subsequent transvaginal pelvic US performed by the Department of Radiology. Patients were followed up for radiology results, need for operative intervention, and ultimate outcome of the pregnancy.<\/jats:p><jats:p> <jats:bold>Results<\/jats:bold>There were 242 patients enrolled, with an average time to complete the EP US of 4 minutes and 27 seconds. There were 28 ectopic pregnancies diagnosed (11.6%), of which 18 patients underwent operative intervention. Free fluid in Morison's pouch was identified in ten patients, nine of whom underwent operative intervention, yielding a positive likelihood ratio of 112 (95% confidence interval = 15 to 831) for patients with suspected ectopic pregnancy who required operative intervention.<\/jats:p><jats:p> <jats:bold>Conclusions<\/jats:bold>Free intraperitoneal fluid found in Morison's pouch in patients with suspected ectopic pregnancy may be rapidly identified at the bedside by EP\u2010performed US and predicts the need for operative intervention.<\/jats:p>","DOI":"10.1197\/j.aem.2007.04.010","type":"journal-article","created":{"date-parts":[[2007,6,7]],"date-time":"2007-06-07T00:55:21Z","timestamp":1181177721000},"page":"755-758","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":86,"title":["Free Fluid in Morison's Pouch on Bedside Ultrasound Predicts Need for Operative Intervention in Suspected Ectopic Pregnancy"],"prefix":"10.1111","volume":"14","author":[{"given":"Chris","family":"Moore","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William M.","family":"Todd","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"O'Brien","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henry","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2008,6,28]]},"reference":[{"key":"e_1_2_1_2_1","first-page":"1010","article-title":"Prompt diagnosis of ectopic pregnancy in an emergency department setting","volume":"84","author":"Barnhart K","year":"1994","journal-title":"Obstet Gynecol"},{"key":"e_1_2_1_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0196-0644(05)81511-2"},{"key":"e_1_2_1_4_1","first-page":"705","article-title":"Centers for Disease Control and Prevention (CDC). Maternal mortality\u2014United States, 1982\u20101996","volume":"47","year":"1998","journal-title":"MMWR Morbid Mortal Wkly Rep"},{"key":"e_1_2_1_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005373-199811000-00006"},{"key":"e_1_2_1_6_1","doi-asserted-by":"publisher","DOI":"10.1053\/ajem.2002.32637"},{"key":"e_1_2_1_7_1","first-page":"117","article-title":"Operative laparoscopy in tubal pregnancy: preoperative ultrasonographic measurement of hemoperitoneum as a predictor of blood loss and outcome","volume":"50","author":"Hsu S","year":"2005","journal-title":"J Reprod Med"},{"key":"e_1_2_1_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1553-2712.2001.tb02110.x"},{"key":"e_1_2_1_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2005.08.023"},{"key":"e_1_2_1_10_1","doi-asserted-by":"publisher","DOI":"10.1197\/aemj.10.1.37"},{"key":"e_1_2_1_11_1","doi-asserted-by":"publisher","DOI":"10.7863\/jum.2004.23.4.459"}],"container-title":["Academic Emergency Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1197%2Fj.aem.2007.04.010","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1197\/j.aem.2007.04.010","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,1]],"date-time":"2023-10-01T22:39:49Z","timestamp":1696199989000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1197\/j.aem.2007.04.010"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2007,8]]},"references-count":10,"aliases":["10.1111\/j.1553-2712.2007.tb01877.x"],"journal-issue":{"issue":"8","published-print":{"date-parts":[[2007,8]]}},"alternative-id":["10.1197\/j.aem.2007.04.010"],"URL":"https:\/\/doi.org\/10.1197\/j.aem.2007.04.010","archive":["Portico"],"relation":{},"ISSN":["1069-6563","1553-2712"],"issn-type":[{"value":"1069-6563","type":"print"},{"value":"1553-2712","type":"electronic"}],"subject":[],"published":{"date-parts":[[2007,8]]},"assertion":[{"value":"2008-06-28","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}