IMPORTANT: We currently have a number of bugs related to image cropping and are actively trying to resolve them. In the meantime, we have disabled cropping. Apologies for any inconvenience. Stay informed: radiopaedia.org/chat

Fimbrial ectopic pregnancy

Case contributed by Ilse Frías Molina
Diagnosis certain

Presentation

First-trimester routine ultrasound. The patient presented with mild pelvic pain. Gestational age of 9 weeks and 5 days by last menstrual period.

Patient Data

Age: 40
Gender: Female
ultrasound

Empty uterus of normal shape, size, and echogenicity.

The endometrium is thickened, measuring 14 mm.

The right ovary seems to be increased in size, inside the right ovary a gestational sac of 30 mm. Inside the sac, an embryo with a crown-rump length of 28.2 mm which corresponds to 9 weeks, 5 days of gestation. Fetal heart rate of 163 beats per minute.

There is no intraperitoneal free fluid.

Surgery was performed identifying an ectopic pregnancy in the fimbria of the fallopian tube embracing the ovary. Thus, the imaging findings resemble an ovarian pregnancy. 

 

Case Discussion

Patients with an ectopic pregnancy present with up to 9 weeks history of amenorrhea, mild pelvic pain and vaginal discharge, however, up to 50% of patients are asymptomatic. Therefore, routine documentation of intrauterine pregnancy is suggested for all patients in their first trimester.

The risk for rupture increases as the ectopic pregnancy enlarges. The severity of pelvic pain does not correlate with the size of the ectopic pregnancy.

Initial evaluation of patients with suspicion of an ectopic pregnancy includes a quantitative measurement of serum human chorionic gonadotropin (hCG) and transvaginal ultrasound.

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.