Unexpected Rupture of an Expectantly Managed Tubal Ectopic Pregnancy: a Reminder for Enhanced Diligence

Overview

Journal BMJ Case Rep

Specialty General Medicine

Date 2020 Jan 1

PMID 31888919

Authors

Amenda Ann Davis

Kusum Lata

Akshita Panwar

Alka Kriplani

Affiliations

Soon will be listed here.

Abstract

Expectant management of tubal ectopic pregnancies is a feasible and possibly preferable method of management in asymptomatic women with low serum β-human chorionic gonadotropin (hCG). This involves serial monitoring of β-hCG until negative, after which it is deemed as spontaneously resolved ectopic pregnancy. We describe a case of tubal ectopic pregnancy which was expectantly managed with an initial β-hCG of 585 mIU/mL until undetectable. This patient presented with ruptured ectopic pregnancy 8 weeks after the original diagnosis, at the level of 5 mIU/mL. This highlights the importance of close monitoring in the expectant management of tubal ectopic pregnancies, with the incorporation of imaging, even when serial β-hCG shows a persistently reducing trend.

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