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Right ovarian Live Ectopic pregnancy

Right ovarian Live Ectopic pregnancy ultrasound case study

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Right ovarian Live Ectopic pregnancy ultrasound case study

CASE–1

Clinical History

Patient presents with amenorrhea, positive urine/serum pregnancy test, lower abdominal pain, and/or vaginal bleeding. The patient was referred for pelvic ultrasound to evaluate the location and viability of the pregnancy.

Ultrasound Findings

Ultrasound examination demonstrates an extrauterine right adnexal gestational sac containing a live embryo with demonstrable cardiac activity. The gestational sac is separate from the right ovary and corresponds to a right tubal ectopic pregnancy. The uterus is empty with no evidence of an intrauterine gestational sac. A corpus luteum is noted within the right ovary. Mild to moderate free fluid may be present in the pouch of Douglas. No sonographic evidence of adnexal rupture is identified.

Report Line

A right ovarian gestational sac containing a live embryo is identified within the right ovary. The crown–rump length (CRL) measures 10.02 mm, corresponding to a calculated ultrasound age (CUA) of 7 weeks 1 day. Fetal cardiac activity is present with a fetal heart rate (FHR) of 147 bpm. No intrauterine gestational sac is identified. Mild free pelvic fluid is present without definite sonographic evidence of rupture. The findings are consistent with a live right ovarian ectopic pregnancy.

Impression

Features are consistent with a live right ovarian ectopic pregnancy. No intrauterine pregnancy is identified. Mild free pelvic fluid is noted without definite sonographic evidence of rupture. Urgent gynecological consultation is recommended.

Key Learning Points

Ovarian ectopic pregnancy is a rare form of ectopic gestation accounting for less than 3% of all ectopic pregnancies.
Ultrasound demonstrates a gestational sac located within the ovarian parenchyma, separate from the fallopian tube.
Visualization of a live embryo with cardiac activity confirms a live ovarian ectopic pregnancy.
An empty uterine cavity in the presence of a positive pregnancy test strongly supports the diagnosis.
Careful assessment for ovarian rupture and hemoperitoneum is essential.
Differential diagnoses include corpus luteum cyst, hemorrhagic ovarian cyst, ruptured ovarian cyst, and tubal ectopic pregnancy.
Prompt diagnosis is important because ovarian ectopic pregnancy is a gynecological emergency.

Recommendation

Immediate gynecological consultation is recommended. Correlation with quantitative serum β-hCG levels and clinical findings is advised. Appropriate medical or surgical management should be instituted promptly based on the patient's hemodynamic status and sonographic findings.