Double decidual sac sign
Citation, DOI, disclosures and article data
Citation:
Gaillard F, Jones J, Elfeky M, et al. Double decidual sac sign. Reference article, Radiopaedia.org (Accessed on 05 Dec 2024) https://doi.org/10.53347/rID-1235
rID:
1235
Article created:
Disclosures:
At the time the article was created Frank Gaillard had no recorded disclosures.
View Frank Gaillard's current disclosures
Last revised:
Disclosures:
At the time the article was last revised Jeremy Jones had no recorded disclosures.
View Jeremy Jones's current disclosures
Revisions:
11 times, by
11 contributors -
see full revision history and disclosures
Systems:
Sections:
Tags:
Synonyms:
- Double decidual sac sign (DDDS)
- Double decidual sign
- Double sac sign
The double decidual sac sign (DDSS) is a useful feature on early pregnancy ultrasound to confirm an early intrauterine pregnancy (IUP) when the yolk sac or embryo is still not visualized. It consists of the decidua parietalis (lining the uterine cavity) and decidua capsularis (lining the gestational sac) and is seen as two concentric rings surrounding an anechoic gestational sac. Where the two adhere is the decidua basalis, and is the site of future placental formation.
If a double decidual sac sign is present (~53% of IUPs) 6, then it is highly suggestive that the intrauterine fluid collection is an intrauterine pregnancy 7. It is absent in many IUPs, however, and its absence does not define a pseudogestational sac 5.
Should a definite IUP not be confirmed on sonography then repeat scanning and serial quantitative beta-HCGs are required, until either an IUP is established, an ectopic pregnancy is visualized, or beta-HCGs returns to zero (implying miscarriage).
References
- 1. Farquharson RG, Stephenson MD. Early Pregnancy. Cambridge Univ Pr. (2010) ISBN:0521517087. Read it at Google Books - Find it at Amazon
- 2. Chudleigh P, Thilaganathan B. Obstetric ultrasound, how, why and when. Churchill Livingstone. (2004) ISBN:0443054711. Read it at Google Books - Find it at Amazon
- 3. Cosby KS, Kendall JL. Practical guide to emergency ultrasound. Lippincott Williams & Wilkins. (2005) ISBN:0781778581. Read it at Google Books - Find it at Amazon
- 4. Yeh HC. Use of the double decidual sac sign and intradecidual sign. J Ultrasound Med. 2011;30 (1): 119-20. J Ultrasound Med (full text) - Pubmed citation
- 5. Doubilet PM. Ultrasound Evaluation of the First Trimester. Radiol. Clin. North Am. 2014;52 (6): 1191-1199. doi:10.1016/j.rcl.2014.07.004 - Pubmed citation
- 6. Doubilet PM, Benson CB. First, do no harm. To early pregnancies. J Ultrasound Med. 2010;29 (5): 685-9. Pubmed citation
- 7. Rodgers SK, Chang C, DeBardeleben JT, Horrow MM. Normal and Abnormal US Findings in Early First-Trimester Pregnancy: Review of the Society of Radiologists in Ultrasound 2012 Consensus Panel Recommendations. Radiographics : a review publication of the Radiological Society of North America, Inc. 35 (7): 2135-48. doi:10.1148/rg.2015150092 - Pubmed
Incoming Links
Related articles: Pathology: Genitourinary
- obstetrics
-
first trimester
- ultrasound findings in early pregnancy
- embryo/fetus
- beta-hCG levels
- confirming intrauterine gestation
- pregnancy of unknown location (PUL)
- first trimester vaginal bleeding
- early structural scan
- aneuploidy testing
-
second trimester
- fetal biometry
- amniotic fluid volume
- fetal morphology assessment
- soft markers
- amnioreduction
- Doppler ultrasound
- nuchal translucency
- 11-13 weeks antenatal scan
- chorionic villus sampling (CVS) and amniocentesis
- other
- placenta
- placental anatomy
- placental developmental abnormalities
- placenta previa
- spectrum of abnormal placental villous adherence
- abnormalities of cord insertion
- abruptio placentae
- placental pathology
- vascular pathologies of placenta
- placental infections
- placental masses
- molar pregnancy
- twin placenta
- miscellaneous
-
first trimester
- gynecology
- acute pelvic pain
- chronic pelvic pain
- uterus
- ovaries
- ovarian follicle
- ovarian torsion
- pelvic inflammatory disease
- ovarian cysts and masses
- paraovarian cyst
- polycystic ovaries
- ovarian hyperstimulation syndrome
- post-hysterectomy ovary
- cervix
- fallopian tube
- other
- male genital tract
- prostate gland
- transrectal ultrasound
- prostate tumors
- infections of the prostate
-
prostatitis
- acute bacterial prostatitis
-
chronic prostatitis
- chronic bacterial prostatitis
- chronic prostatitis and chronic pelvic pain syndrome (CPPS)
- asymptomatic inflammatory prostatitis
- granulomatous prostatitis
- emphysematous prostatitis
- prostatic abscess
-
prostatitis
- benign prostatic hypertrophy
- cystic lesions of the prostate
- prostatic calcification
- prostatic infarction
- testes
-
unilateral testicular lesion
- testicular torsion
- orchitis
- testicular trauma
-
germ cell tumors of the testis
- testicular seminoma
-
non seminomatous germ cell tumors
- mixed germ cell tumor
- yolk sac tumor (endodermal sinus tumor)
- embryonal cell carcinoma
- choriocarcinoma
- testicular teratoma
- testicular epidermoid (teratoma with ectodermal elements only)
- burned out testis tumor
- sex cord / stromal tumors of the testis
- testicular cyst
- testicular lymphoma
- bilateral testicular lesion
- paratesticular lesions
- epididymis
- other
- polyorchidism
- cryptorchidism
- tubular ectasia of the rete testis
- cystadenoma of the rete testis
- testicular sarcoidosis
- testicular tuberculosis
- spermatic cord
- fibrous pseudotumor of the scrotum
- scrotal leiomyosarcoma
- testicular adrenal rest tumors (TARTs)
- tunica vaginalis testis mesothelioma
- splenogonadal fusion
- testicular vasculitis
- abnormal testicular Doppler flow (differential)
-
unilateral testicular lesion
- penis
- prostate gland
- KUB
- kidneys
- normal renal anatomy
- hydronephrosis
- urolithiasis
- renal masses
- renal cystic disease
- renal infection
- vascular
- trauma
- ureter
- normal ureter anatomy
- ureteral stricture
- ureteral dilatation
- ureteral anomalies
- ureteral tumors
- ureteral trauma
- other
- bladder
- kidneys