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Pregnant lady has a 93 positive predictive value for ectopic Pregnancy

Although hemoperitoneum in the pouch of Douglas in a pregnant lady has a 93 positive predictive value for ectopic pregnancy other causes of hemoperitoneum include ruptured ovarian cysts or corpus luteum placenta accreta and spontaneous abortion must be borne in mind The corpus luteum of pregnancy may sometimes be confused with the gestational sac It is situated in the ovary unlike a tubal ectopic and typically has high T1 signal intensity in its wall whereas it is homogenously hypointense in an unruptured gestational sac It is not associated with acute haemorrhage and resolves spontaneously regressed by the end of the second trimester Post contrast fat suppressed images after an intrauterine pregnancy has been excluded can help better delineate the gestational sac when there is difficulty in identification of the sac within a tubal hematoma or hemoperitoneum these are usually well enhancing thick sac like structures the middle layer of the trilamellar sac enhances and clearly visualized even in the background of hematoma Tubal enhancement related to increased vascularity post implantation and enhancing papillary projections of placental tissue may be identified within the tube reported in 81 of the cases 

1 pages | 374 words