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7 week pregnant female, due for TOP in 2/7's, presents with increasing LIF pain, minimal focal tenderness on examination, stable hemodynamics and no abnormal PV bleeding. Quantitative beta HCG is pending. ? ectopic pregnancy/other cause for pain.
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Obstetric ultrasound: Transabdominal and transvaginal images obtained. No focal tenderness elicited. Uterus measures 7.7cm (trans) X 8.5cm (long) X 6.4cm (AP). The uterine cavity demonstrates a small gestational sac measuring 5.5mm, with an estimated gestational date of 5 weeks, 1 day. Right ovary measures 3.6cm X 2.1cm X 2.3cm and demonstrates a 1.3mm ovoid hypoechoic focus, without internal contents, consistent with a simple cyst. Left ovary measures 2.4cm X 2.4cm X 3cm and demonstrates a small focus of hypervascularity most likely representing a corpus luteum. No pelvic free fluid.
This case highlights the ultrasonographic findings of a small, simple right ovarian cyst in the presence of a uterine pregnancy with calculated gestation of 5 weeks, 1 day.
Acknowledgement: Dr Christen Barras