Case 05: Ectopic Pregnancy Ultrasound

Introduction:

Implantation of blastocyst in an abnormal location represents ectopic pregnancy. Ruptured ectopic is an emergency condition, needs rapid diagnosis and management.

Clinical Features:

Reproductive aged female patient came with the history of
1. Amenorrhoea for 2 months followed by per vaginal bleeding.
2. Severe lower abdominal pain, more on the right side.
3. Severe pain during defecation and micturition.

Patient's recent serum beta hCG level was more than 11000.

Ultrasound Findings:

1. Uterus is bulky. An irregular fluid collection without any fetal pole is noted within the endometrial cavity representing pseudo-gestational sac. (Not well shown in the figures).

2. Right tubo-ovarian region shows an irregular small gestational sac of 8.8 mm diameter, surrounded by an irregular thick wall forming donut sign, without any feta pole inside.

3. Color Doppler shows relatively low resistance pattern of arterial supply (RI: 0.5) around the sac along with peripheral 'Ring of Fire' appearance.

4. Mild pelvic collection is noted.

Images:

Features Highly Suggestive Of:

Ruptured right adnexal ectopic pregnancy.


Scanning was done on the 06.06.18 at 3-4am.