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Pregnant. Ultrasound showed an empty uterus and an adnexal mass. What does this mean?

May 2013
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Practicing since : 2006
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hi! my wife is pregnant around 4-6 weeks (not sure yet).. we just had an ultrasound 2 days ago.
please help me with this findings..

I. uterus 5.76 x 4.99 x 5.63 anteverted
myoma "none"
adenomyosis "none"
II. endometrium thick 1.72 cm. hyperechoic
compatible width: phase of menstrual cycle
abnormalities: the endometrium is thickened and hyperechoic, probably decidualized.
III. adnexae:
right ovary 3.40 x 1.88 x 2.62 cm.
located: lateral
dominant follicle: 0 cm.
abnormalities noted: within the right ovary is a thin walled, unilocular cystic structure with crenated borders and ring of fire on color, measuring 1.514 x 1.22 cm. suggestive of corpus luteum.
left ovary 0 x 0 x cm.
located: lateral
dominant follicle: 0 cm.
abnormalities noted: the left ovary was not visualized. There is a complex mass seen within the left adnexa measuring 2.94 x 2.93 x 2.74 cm. with a unilocular cystic structure within, with crenated borders measuring 1.53 x 1.44 cm. Extrauterine gestation cannot be totally ruled out.
IV. Cervix: 2.93 x 2.24 x 2.17 cm no nabothian present.
V. Others: No free fluid in cul de sac
normal sized anteverted uterus
thickened endometrium, probably decidualized
normal right ovary with corpus luteum
left ovary not visualized
left adnexal mass as described
in the light of a positive pregnancy test, an empty uterus and an adnexal mass, extrauterine gestation cannot be ruled out.
suggest correlation with clinical findings, serum beta HCG and serial scanning for evaluation of the left adnexal mass.
Posted Sat, 8 Jun 2013 in Pregnancy
Answered by Dr. Sree Gouri SR 30 minutes later
Thanks for the query.

There is possibility of ectopic pregnancy, as:
-The intrauterine gestational sac not visualized even after around 6 weeks of pregnancy.
-Decidual reaction is present in the uterus.
-Pregnancy test is positive, corpus luteum of pregnancy is present in right ovary.
-Complex mass suggestive of ectopic gestational sac present in the left adnexa.

So as your doctor suggested go for:
Beta HCG levels, if the levels are elevated but less than the expected range of normal pregnancy, it suggests ectopic pregnancy.
Repeat ultrasound after one week to visualize the changes in uterus and adnexa.

If she gets pain abdomen or spotting etc within this period better to consult the doctor immediately.

Hope I have answered your query. I will be available to answer your follow up queries. If you are satisfied with all my answer, please rate the answer after closing the discussion.
Take care.
Above answer was peer-reviewed by
Follow-up: Pregnant. Ultrasound showed an empty uterus and an adnexal mass. What does this mean? 7 minutes later
then what will happen? is it normal? does it mean that we will lose our baby.. is it critical? what should we do? and what do you mean by ectopic pregnancy? and yes she gets pain in abdomen.. what is beta hcg test? how was it done..
Answered by Dr. Sree Gouri SR 2 hours later

Ectopic pregnancy means development of gestational sac in areas other than uterus.
It is a abnormal pregnancy.
If the ectopic is confirmed the pregnancy cannot be continued.
Now you have to go for beta HCG levels.
It is a blood test to analyze the beta HCG levels in the body. These levels will be elevated in pregnancy. But in ectopic pregnancy the elevation is less compared with normal pregnancy.
So by calculating the levels ectopic can be identified. And repeat scan helps in confirmation of ectopic.
If the ectopic pregnancy confirms that should be removed.
And this should be done before rupturing of the sac as that can become a emergency.
Before rupture of the sac by medical or surgical methods ectopic pregnancy can be terminated.
For more details:

Wish you Good Health, If you are satisfied with my response please rate the answer after closing the discussion.
Take care.
Above answer was peer-reviewed by
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