Pelvic ultrasound has been for many years an important tool in the evaluation of the pregnant female. This is now the standard of care in the evaluation of possible ectopic pregnancy for patients with first trimester pain or bleeding.

Due to the difficult nature of this exam, ED screening US is limited only to identifying a definite in utero pregnancy. This is true when utilizing trans-abdominal and endovaginal probes. There should always be a low threshold for obtaining an immediate formal study in females where the screening exam is not totally conclusive.

This limited exam is not and should not be considered a complete formal evaluation in first trimester of pregnancy. But, when performed correctly, it can save both hospital resources and patient time by identifying an intrauterine pregnancy and allowing the patient to be safely discharged with follow-up evaluation and studies the next day