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Advanced ectopic pregnancy

Case contributed by Bruno Di Muzio
Diagnosis almost certain

Presentation

History of pregnancy (β-hCG positive) and mild pelvic pain for the last 24 hours. No vaginal spotting.

Patient Data

Age: 20 years
Gender: Female

Obstetric ultrasound

ultrasound

Transvaginal grey-scale US image reveals an adnexal mass with gestational sac and a normal live 11 weeks embryo within. Normal heart beat of the embryo demonstrated. The uterus has normal size and an empty endometrial cavity. No signs of hemoperitoneum. 

Case Discussion

Transvaginal US images reveal a right adnexal mass with gestational sac and a normal 11-week embryo. The ovary itself was not identified on imaging. 

Surgery and anatomopathological study confirmed right ovarian ectopic pregnancy.

Ovarian ectopic pregnancy is rare, estimated ranging from 0.5 to 3.0% of all ectopic gestations 1. The ovaries are described with a capacity to accommodate an ectopic pregnancy without rupture for longer than the tubes, such as in this case, although about 75% of ovarian gestations will rupture early in the first trimester 1

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