Case Report of an Undisturbed Ectopic Pregnancy with Very High Human Chorionic Gonadotrophin (Î²-hCG)

This is a case report of a patient with an undisturbed ectopic pregnancy and very high levels of human chorionic gonadotrophin (β-HCG). The patient presented to the emergency room at 9+1 weeks of gestation with mild abdominal pain and vaginal bleeding. She had an obstetric history of two previous cesarean section deliveries. On presentation, her human chorionic gonadotropin (β-HCG) was measured to be 26,530 mIU/ml, and after 18 hours, the β-HCG level was 25,660 mIU/ml. An ultrasound scan revealed no evidence of intrauterine pregnancy, a left ovarian cyst measuring 2.86 cm x 2.17 cm, and the presence of a mixed mass near the ovary measuring 3.92 cm x3.62 cm. The patient was diagnosed with a left tubal ectopic pregnancy and was taken for an immediate laparoscopy. Intraoperatively, the left tubal ectopic pregnancy was undisturbed and measured about 4-5 cm involving more than half of the fallopian tube. The mixed mass, along with the left fallopian tube, was removed as a whole. Keywords: Abdominal pain, Cesarean Section, Ectopic-pregnancy, Laparoscopy, Tubal pregnancy, Ultrasonography

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Pre-treatment human chorionic gonadotrophin (hCG) ratio in the management of non-tubal ectopic pregnancy

Ceylon Medical Journal ◽

10.4038/cmj.v56i2.3113 ◽

2011 ◽

Vol 56 (2) ◽

pp. 70

Author(s):

D Alhamdan ◽

T Bignardi ◽

I Casikar ◽

J Riemka ◽

G Condous

Keyword(s):

Ectopic Pregnancy ◽

Chorionic Gonadotrophin ◽

Human Chorionic Gonadotrophin ◽

Tubal Ectopic Pregnancy ◽

Pre Treatment

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Endometrial cysteine-rich secretory protein 3 is inhibited by human chorionic gonadotrophin, and is increased in the decidua of tubal ectopic pregnancy

MHR Basic science of reproductive medicine ◽

10.1093/molehr/gap019 ◽

2009 ◽

Vol 15 (5) ◽

pp. 287-294 ◽

Cited By ~ 11

Author(s):

A.W. Horne ◽

W.C. Duncan ◽

A.E. King ◽

S. Burgess ◽

P.C. Lourenco ◽

...

Keyword(s):

Ectopic Pregnancy ◽

Secretory Protein ◽

Chorionic Gonadotrophin ◽

Human Chorionic Gonadotrophin ◽

Tubal Ectopic Pregnancy

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Levonorgestrel intrauterine system embedded within tubal ectopic pregnancy: a case report

Journal of Medical Case Reports ◽

10.1186/s13256-021-02723-7 ◽

2021 ◽

Vol 15 (1) ◽

Author(s):

Dorothy Makena ◽

Ingrid Gichere ◽

Khadija Warfa

Keyword(s):

Case Report ◽

Ectopic Pregnancy ◽

Fallopian Tube ◽

Intrauterine Device ◽

African Woman ◽

Rare Occurrence ◽

Intrauterine Pregnancy ◽

Case Presentation ◽

Tubal Ectopic Pregnancy ◽

Left Fallopian Tube

Abstract Background The presence of the levonorgestrel-releasing intrauterine system embedded within an ectopic pregnancy is a rare occurrence. Tubal migration of an intrauterine device is not well understood and has not been extensively studied in literature. Case presentation A 34-year-old African woman, para 1, gravida 2, presented with symptoms of ruptured ectopic pregnancy. She underwent a laparoscopy where a ruptured left ectopic pregnancy was found with a levonorgestrel-releasing intrauterine system inserted 2 years prior embedded within the tube. A left salpingectomy was performed with removal of the levonorgestrel-releasing intrauterine system. The patient recovered well and proceeded to have an intrauterine pregnancy 3 months later. Conclusion Migration of the levonorgestrel-releasing intrauterine system into the fallopian tube is a rare occurrence that is not well understood. In the case presented, levonorgestrel-releasing intrauterine system was found embedded within the fimbrial end of the left fallopian tube, which had a ruptured ectopic pregnancy. Surgical treatment with laparoscopy is recommended for intraabdominal intrauterine device to prevent complications.

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Ruptured tubal ectopic pregnancy associated with negative qualitative human chorionic gonadotrophin levels

Australian and New Zealand Journal of Obstetrics and Gynaecology ◽

10.1111/j.1479-828x.2000.tb01182.x ◽

2000 ◽

Vol 40 (4) ◽

pp. 459-460 ◽

Cited By ~ 2

Author(s):

Judith TW Goh ◽

Mukhtlar S Sidhu

Keyword(s):

Ectopic Pregnancy ◽

Chorionic Gonadotrophin ◽

Human Chorionic Gonadotrophin ◽

Tubal Ectopic Pregnancy

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Tubal Stump Ectopic: A Case Report on Repeat Ipsilateral Tubal Ectopic Pregnancy

Case Reports in Obstetrics Gynecology and Reproductive ◽

10.31487/j.crogr.2021.01.01 ◽

2021 ◽

pp. 1-3

Author(s):

Maryam Rahim ◽

Shikha Aggarwal

Keyword(s):

Abdominal Pain ◽

Northern Ireland ◽

Ectopic Pregnancy ◽

Adnexal Mass ◽

Tubal Ectopic Pregnancy ◽

Mild Abdominal Pain ◽

Pouch Of Douglas ◽

Β Hcg ◽

Laparoscopic Salpingectomy ◽

Infrequent Event

Background: Tubal Stump Ectopic is an infrequent event with critical obstetrical consequences. A case is illustrated from Northern Ireland in which an ectopic pregnancy was discovered in the tubal stump previously undergone salpingectomy. Case Facts: A 34-year-old woman (G2 E1) with a tubal stump ectopic of a previous cornual excision two years prior, presented to EPAU complaining of mild abdominal pain and 6 weeks amenorrhoea. She was clinically stable (β-hCG 1407 mIU/mL), while TVUS revealed no evidence of IUP or adnexal mass but fluid in the Pouch of Douglas. Laparoscopic salpingectomy was performed after a diagnosis of tubal stump ectopic. Inference: Women who has had a previously ectopic pregnancy are at a significantly greater probability of relapse. To correctly and quickly identify the implanted location, a TVUS should be conducted. Laparoscopic diagnostic salpingectomy should be performed through excision by diathermy to prevent the risk of EP in the tubal stump.

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