Presentation
History of right ectopic pregnancy with right salpingectomy. Currently, got pregnant with normal rising B-HCG came for early pregnancy assessment and complaining of pervaginal bleeding.
Patient Data
Intact left tubal live ectopic pregnancy is noted, with gestational age averaging 6 weeks and 3 days and active pulsations (~150 b/min). No surrounding hematosalpinx noted.
Left ovarian cyst averages 1.7 cm with slightly turbid content and "ring of fire" peripheral color Doppler pattern, suggestive of corpus luteum cyst of pregnancy.
Case Discussion
Intact tubal live ectopic pregnancy. Tubal ectopic pregnancy is the commonest type of ectopic pregnancy, with the ampullary portion the commonest. A gestational sac that is just separate from the ovary is likely ampullary ectopic pregnancy. No associated hematosalpinx in this case, which is a common association. It shows tubal ring sign, appears as an echogenic ring that surrounds the unruptured ectopic pregnancy.
Corpus luteum cyst is seen in this case with similar Doppler features "ring of fire", a common finding of early pregnancy that shouldn't be mistaken for an ectopic gestational sac (see the last video).
The patient underwent left salpingectomy.
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