- Scan should be offered without delay in cases of abdominal/pelvic pain with no previous scan showing live intrauterine pregnancy, heavy bleeding with systemic symptoms or high suspicion of ectopic pregnancy.
- In cases of moderate bleeding or resolved heavy bleeding, it is suggested to use teleconsultation and ask the patient to take a pregnancy test. If negative, no follow-up is necessary. If positive, an ultrasound should be performed.
- When the indication for the scan are reassurance, previous miscarriage or light bleeding without other symptoms, phone call with no routine scan should be considered.
Recommended action according to scan findings :
- Intrauterine pregnancy should not be offered follow-up scan. When the viability is unknown and the date does not fit with menstrual dates, urine pregnancy test with phone call follow-up should be considered two weeks later.
- A blood test measuring B-HCG ± progesterone is suggested for pregnancy of unknown location. The follow-up plan needs to consider the risk of failing or ectopic pregnancy.
- In case of ectopic pregnancy, conservative management should be prioritised and the use of methotrexate should be discussed with an multidisciplinary team. When surgical approach is necessary, laparoscopy should be performed while using strict precautions.
- Miscarriage could be managed the usual way, using surgical or medical procedure. A pregnancy test and a teleconsultation are suggested three weeks after the procedure.
- When molar pregnancy is suspected, systemic condition of the patient should be assessed by experienced clinician.
This data comes from a consensus statement by the International Society of Ultrasound in Obstetrics and Gynecology about early-pregnancy care during the pandemic.
- Bourne T., Kyriacou C. and al. (April 3 2020) ISUOG Consensus Statement on rationalization of early-pregnancy care and provision of ultrasonography in context of SARS-CoV-2. International Society of Ultrasound in Obstetrics and Gynecology. Retrieved from : https://www.isuog.org/resource/isuog-consensus-statement-on-rationalization-of-early-pregnancy-care-and-provision-of-ultrasonography-in-context-of-sars-cov-2-pdf.html