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Ovarian
ectopic pregnancy

Ovarian ectopic pregnancy ultrasound case study

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Ovarian ectopic pregnancy pregnancyultrasound case study

CASE–1

Clinical History

A reproductive-age female presented with amenorrhea, mild lower abdominal pain, and a positive urine/serum β-hCG. A transvaginal ultrasound (TVS) was performed to evaluate the location and viability of the pregnancy.

Transvaginal Ultrasound Findings

Transvaginal sonography demonstrates an empty uterine cavity with no evidence of an intrauterine gestational sac. A well-defined gestational sac is identified within the left ovary measuring 11 mm mean sac diameter (MSD), corresponding to an estimated gestational age of 5 weeks 0 days. A yolk sac is clearly visualized within the gestational sac. No definite fetal pole or cardiac activity is identified at this stage. Adjacent to the gestational sac, a 10 × 8 mm corpus luteum cyst is seen within the left ovary demonstrating peripheral hypervascularity ("ring of fire" sign) on color Doppler examination. The right ovary appears normal. No significant free fluid is seen in the pelvis.

Transvaginal ultrasound. A left ovarian gestational sac containing a yolk sac (MSD 11 mm, approximately 5 weeks gestation) is demonstrated. An adjacent 10 × 8 mm corpus luteum cyst shows peripheral vascularity ("ring of fire" sign). Findings are consistent with a left ovarian ectopic pregnancy.

Report Line

Ultrasound demonstrates an empty uterine cavity. A left ovarian gestational sac measuring 11 mm MSD (approximately 5 weeks 0 days) containing a yolk sac is identified. An adjacent 10 × 8 mm corpus luteum cyst demonstrates peripheral "ring of fire" vascularity on color Doppler. No fetal pole or cardiac activity is identified. No significant pelvic free fluid is present. Sonographic findings are consistent with an early left ovarian ectopic pregnancy.

Impression

Features are consistent with an early left ovarian ectopic pregnancy with a gestational sac and yolk sac (MSD 11 mm, approximately 5 weeks 0 days). An adjacent left ovarian corpus luteum cyst (10 × 8 mm) with peripheral vascularity is also present.

Recommendation

Urgent obstetric/gynecological consultation is recommended. Correlation with serial quantitative serum β-hCG levels is advised. Follow-up transvaginal ultrasound should be performed to assess interval development and viability. Clinical monitoring is essential due to the risk of rupture associated with ovarian ectopic pregnancy.

Key Learning Points

Ovarian ectopic pregnancy is a rare form of ectopic pregnancy, accounting for less than 3% of all ectopic pregnancies.
Visualization of a gestational sac with a yolk sac within the ovary is highly suggestive of ovarian ectopic pregnancy.
The "ring of fire" sign may be seen in both ectopic pregnancy and corpus luteum cyst and should be interpreted with grayscale findings.
An empty uterine cavity with a positive β-hCG should prompt careful evaluation of both adnexa.
Early diagnosis reduces the risk of ovarian rupture and life-threatening hemorrhage.
Serial β-hCG measurements and follow-up TVS are important for management.