A case of tubal pregnancy presenting with acute abdomen at 14 weeks gestation

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  • SHINGAKI Kana
    Department of Obstetrics and Gynecology, Uji Tokushukai Hospital
  • MIYAZAKI Nodoka
    Department of Obstetrics and Gynecology, Uji Tokushukai Hospital
  • KAWABE Koji
    Department of Obstetrics and Gynecology, Uji Tokushukai Hospital
  • TAKADA Shuichi
    Department of Obstetrics and Gynecology, Uji Tokushukai Hospital

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Other Title
  • 妊娠14週まで無症状で継続した後,急性腹症を呈した卵管膨大部妊娠の1症例
  • ニンシン 14シュウ マデ ムショウジョウ デ ケイゾク シタ アト,キュウセイ フクショウ オ テイシタ ランカン ボウダイブ ニンシン ノ 1 ショウレイ

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A 41-year-old woman, gravida 0, para 0, who received an infertility treatment and whose urine hCG was positive after a third round of artificial insemination with husband’s spermatozoa (AIH), was referred to our hospital because of acute abdominal pain 88 days after AIH (gestational age ; 14 weeks, 4 days). She was in shock, and we performed a vaginal ultrasound that showed no gestational sac in her uterus, but a 5 cm living fetus outside the uterus. Magnetic resonance imaging (MRI) showed an oval and well-defined GS and a crescent-shaped placenta. We performed a laparotomy, in suspicion of a tubal or abdominal pregnancy; 1040 ml of blood were drained, and we recognized a 5 cm fetus in a ruptured left adnexa. The ruptured site was the ampulla of the left ovarian tube, and a left salpingectomy was performed. She was discharged on the sixth postoperative day in good health. She had experienced a very rare case of tubal pregnancy at 14 weeks gestation without any symptoms. The images of an oval GS and/or a crescent-shaped placenta on the MRI may be helpful for distinguishing an advanced tubal pregnancy from an abdominal pregnancy. [Adv Obstet Gynecol, 67(2) : 67-73 , 2015 (H27.5)]

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