Journal of the Bahrain Medical Society
Year 2021, Volume 33, Issue 3, Pages 41-45
https://doi.org/10.26715/jbms.33_2021_3_7Gulmeen Raza1*, Maha Abdelwahab Ghorabah2
1Senior Registrar, Department of Obstetrics and Gynecology, King Hamad University Hospital, Kingdom of Bahrain.
2Postgraduate Diploma in Health Professions Education at Royal College of Surgeons in Ireland, Consultant & Training Program Director, Department of Obstetrics and Gynecology, King Hamad University Hospital, Kingdom of Bahrain.
*Corresponding author:
Gulmeen Raza, MRCOG, FCPS, MCPS, Senior Registrar, Department of Obstetrics and Gynecology, King Hamad University Hospital, Kingdom of Bahrain. Email: gulmeen.raza@khuh.org.bh
Received date: March 23, 2021; Accepted date: June 15, 2021; Published date: September 30, 2021
Abstract
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