addressing the use of bedside pelvic sonography in the pregnant female In general, if an IUP is not seen in a patient with a positive urine B-HCG, gynecology consultation should be arranged A low-serum HCG level, implying an early IUP, may allow outpatient follow-up with precautions for possible ectopic pregnancy Pitfalls A pregnancy less than weeks’ gestational age (3 weeks post conception) may not be visible The gestational sac should be located off-center and should have a circular appearance; elliptically shaped, centrally located sacs are concerning for an abnormal sac that may not be representative of an IUP Kidney Ultrasound Kidney ultrasound provides important diagnostic information in patients presenting with hematuria and/or abdominal pain Nephrolithiasis is an increasingly recognized cause of pediatric abdominal pain and bedside ultrasound offers the ability to quickly determine a diagnosis in the patient presenting with obstructive nephropathy Early obstruction may initially only result in hydroureter but as the obstruction persists, hydronephrosis will develop Identification of hydronephrosis in a patient with undifferentiated abdominal pain can help to focus further treatments for presumed nephrolithiasis and often precludes the need for additional diagnostic tests While nephrolithiasis is the most common cause of acute obstructive nephropathy, the possibility of extrinsic compression should also be considered Ultrasound has become the first-line imaging modality in cases of suspected renal colic The pediatric literature is limited to case reports regarding the use of bedside ultrasound for evaluation of renal pathology In contrast, adult literature has shown that bedside ultrasound is sensitive and specific for identification of hydronephrosis secondary to obstructive uropathy in patients with renal colic Anatomy Bilateral kidneys are located in the retroperitoneum, with the left kidney located slightly more cephalad than the right The kidneys are obliquely oriented with the upper pole oriented medially and posteriorly The kidney, along with the adrenal gland, is surrounded by Gerota fascia, a hyperechoic linear structure The outer layer of the kidney comprises the renal cortex, a hypoechoic homogeneous tissue with anechoic-appearing medullary pyramids interspersed In the central kidney the calyces, which appear hyperechoic due to the fat in the area, converge to form