Pseudogestational sac


  • Occurs in 5 percent of ectopic pregnancies
  • Irregular fluid collection, centrally within endometrial cavity
  • Irregular shape
  • No double decidual reaction
  • No yolk sac
  • May be difficult to differentiate from early intrauterine pregnancy or decidual cyst
  • A decidual cyst and early gestational sac are usually eccentric
  • A pseudosac is central and often contains blood clot or mobile debris.


Free fluid or haemoperitoneum


  • Describe free fluid as simple or complex.
  • Quantify the amount, that is, small, moderate, large, deepest pocket, confined to pelvis, present in upper abdomen, etc. Document fluid at or above the uterine fundus.
  • If small amount of simple fluid, ectopic is likely not ruptured.
  • A small amount of complex fluid does not always indicate rupture. This can be due to leak from the end of the tube, but early rupture is not excluded.
  • A moderate to large amount of complex fluid / haemoperitoneum is suggestive of rupture.