The need to monitor newer fertility treatments and their resulting conceptions has been a major force behind the development and widespread adoption of trans vaginal sonography (TVS) over the past 15 years. This has led to a large and ever-increasing body of information on the serial sonographic appearance of early pregnancies. The focus of this article is how to use this information to answer important clinical questions that inevitably arise in the early first trimester of a pregnancy. Is the pregnancy intrauterine? Are there multiple gestations? Is the pregnancy viable? Is the pregnancy progressing appropriately? What is the significance of the first trimester bleeding?
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