Live ectopic tubal pregnancy

Case contributed by Dr Mostafa El-Feky

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

Age: 30 years
Gender: Female
Ultrasound

Early pregnancy scan

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 pregnancyTubal 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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Case information

rID: 82171
Published: 16th Sep 2020
Last edited: 10th Apr 2021
System: Obstetrics
Inclusion in quiz mode: Included
Institution: Egy Rad

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