Interstitial ectopic pregnancy

Case contributed by Dr Matthew Lukies

Presentation

Spotting blood per vagina for 3 weeks, then 2 days of heavy PV bleed. Crampy lower abdominal pain and diarrhoea.

Patient Data

Age: 40 year-old
Gender: Female
Modality: Ultrasound
  • anteverted uterus of normal non-pregnant size
  • no gestational sac within the endometrial cavity
  • right sided corpus luteum
  • approximately 2 cm rounded hyperechoic focus with a thin line of communication back to the endometrium
    • there is a very thin amount of myometrium overlying the hyperechoic focus
  • the left ovary is unremarkable
  • no free fluid seen in the pelvis

Case Discussion

This case is a typical demonstration of an interstitial ectopic pregnancy, with a thin surrounding myometrial layer (myometrial mantle) and hyperechoic line from the mass to the endometrium (interstitial line sign).

The patient in this case was not on the oral contraceptive pill and had a bHCG of 1300. She was treated with IM methotrexate and serial bHCG follow up.

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Case Information

rID: 43700
Case created: 22nd Mar 2016
Last edited: 10th Jan 2017
System: Gynaecology
Inclusion in quiz mode: Included

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