title: Check the Head: Emergency Ultrasound Diagnosis of Fetal Anencephaly.
abstract: BACKGROUND
  Early pregnancy complaints in emergency medicine are common. Emergency physicians (EP) increasingly employ ultrasound (US) in the evaluation of these complaints. As a result, it is likely that rare and important diagnoses will be encountered. We report a case of fetal anencephaly diagnosed by bedside emergency US in a patient presenting with first-trimester vaginal bleeding.
  
  
  METHODS
  A 33-year-old patient at 10 weeks gestation presented with vaginal bleeding. After initial history and physical examination, a bedside US was performed. The EP noted the abnormal appearance of the fetal cranium and anencephaly was suspected. This finding was confirmed by a consultative high-resolution fetal US. Making the diagnosis at the point of care allowed earlier detection and more comprehensive maternal counseling about pregnancy options. This particular patient underwent elective abortion which was able to be performed at an earlier gestation, thus decreasing maternal risk. If this diagnosis would not have been recognized by the EP at the point of care, it may not have been diagnosed until the second trimester, and lower-risk maternal options would not have been available.
authors.affiliation: West Virginia University School of Medicine, Department of Emergency Medicine, Morgantown, West Virginia.
authors.forename: John W
authors.initials: JW
authors.lastname: Hall
authors.affiliation: West Virginia University School of Medicine, Department of Emergency Medicine, Morgantown, West Virginia.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Denne
authors.affiliation: West Virginia University School of Medicine, Department of Emergency Medicine, Morgantown, West Virginia.
authors.forename: Joseph J
authors.initials: JJ
authors.lastname: Minardi
authors.affiliation: West Virginia University School of Medicine, Department of Emergency Medicine, Morgantown, West Virginia.
authors.forename: Debra
authors.initials: D
authors.lastname: Williams
authors.affiliation: West Virginia University School of Medicine, Department of Emergency Medicine, Morgantown, West Virginia.
authors.forename: B J
authors.initials: BJ
authors.lastname: Balcik
mesh_terms: D000028:Abortion, Induced; D000328:Adult; D000757:Anencephaly / Q000000981:diagnostic imaging*; D004636:Emergency Service, Hospital; D005260:Female; D005315:Fetal Diseases / Q000000981:diagnostic imaging*; D005865:Gestational Age; D006801:Humans; D019095:Point-of-Care Systems; D011247:Pregnancy; D011248:Pregnancy Complications / Q000000981:diagnostic imaging*; D011261:Pregnancy Trimester, First; D016216:Ultrasonography, Prenatal; D014592:Uterine Hemorrhage / Q000000981:diagnostic imaging