Actively leaking ectopic pregnancy

Case contributed by Dennis Odhiambo Agolah , 22 Mar 2022
Diagnosis certain
Changed by Dennis Odhiambo Agolah, 22 Mar 2022

Updates to Study Attributes

Findings was changed:

A trans-abdominal targeted intra-abdominal-pelvic sonographic evaluation yield a thick-walled, echogenic and internally irregularly outlined fluid-filled structure located within the right adnexal region/ipsilateral infero-medial right para-ovarian aspect and there is a conspicuous echogenic acardiac focus (intrinsically sighted within the aforementioned structure)  corresponding to 7 weeks gestation by crown-rump length. moderate Moderate low level echo-filled free fluid is noted within the Douglas pouch and extending into the right upper abdominal quadrant consistent with haemorrhage/haemoperitoneum. Both ovaries appeared bilaterally normal with the right ovary exhibiting a normal looking corpus luteum. The anteverted and non-gravid uterus exhibited smooth outer contours with no focal myometrial/endometrial lesions.

Updates to Case Attributes

Body was changed:

In the setting of a positive pregnancy test, amenorrhoea and a clinical question to exclude an ectopic pregnancy, urgent and a targeted abdominal-pelvic ultrasound imaging comes in handy as part of the clinical management. In this scenario, the sonographic features unequivocally pointed towards a leaking right sided extra-uterine ectopic pregnancy following theand, the subsequent quantitative laboratory serum beta HCG titre level of 4731 mIU/mL which further strengthened the diagnosis. The ectopic gestational sac however, demonstrated insignificant peripheral hyperfusion (atypical ring of fire; on colour Doppler mapping). The acardiac intra-gestational sac focus also suggested an embryonic demise at seven weeks gestation.

  • -<p>In the setting of a positive pregnancy test, <a href="/articles/amenorrhoea">amenorrhoea </a>and a clinical question to exclude an <a href="/articles/ectopic-pregnancy">ectopic pregnancy</a>, urgent and a targeted abdominal-pelvic ultrasound imaging comes in handy as part of the clinical management. In this scenario, the sonographic features unequivocally pointed towards a leaking right sided extra-uterine ectopic pregnancy following the subsequent quantitative laboratory <a href="/articles/serum-beta-hcg">serum beta HCG</a> titre level of 4731 mIU/mL which further strengthened the diagnosis. The ectopic gestational sac however, demonstrated insignificant peripheral hyperfusion (atypical ring of fire; on colour Doppler mapping). The acardiac intra-gestational sac focus also suggested an <a title="embryonic demise" href="/articles/failed-early-pregnancy">embryonic demise</a> at seven weeks gestation.</p>
  • +<p>In the setting of a positive pregnancy test, <a href="/articles/amenorrhoea">amenorrhoea </a>and a clinical question to exclude an <a href="/articles/ectopic-pregnancy">ectopic pregnancy</a>, urgent and a targeted abdominal-pelvic ultrasound imaging comes in handy as part of the clinical management. In this scenario, the sonographic features unequivocally pointed towards a leaking right sided extra-uterine ectopic pregnancy and, the subsequent quantitative laboratory <a href="/articles/serum-beta-hcg">serum beta HCG</a> titre level of 4731 mIU/mL further strengthened the diagnosis. The ectopic gestational sac however, demonstrated insignificant peripheral hyperfusion (atypical ring of fire; on colour Doppler mapping). The acardiac intra-gestational sac focus also suggested an <a href="/articles/failed-early-pregnancy">embryonic demise</a> at seven weeks gestation.</p>

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