Multan, Pakistan

This is a scan of a 19-year-old woman G2P1A0, presenting with eight weeks amenorrhea, dull lower abdominal pain and mild bleeding (spotting). Her pregnancy test was positive.

A right-sided ectopic pregnancy, with intact gestational sac, and a single live fetus of 7 weeks size was noted. The heart rate was 170beats/min. The patient refused immediate surgery. She came for surgery 7 hours later and a repeat ultrasound scan showed a small collection in the pouch of Douglas and the ectopic gestational sac was noted to have collapsed and was irregular in shape.
At surgery, a ruptured ectopic gestation with a small amount (approximately 200ml) of blood in peritoneal cavity was observed in the ampullary part of the right fallopian tube. A partial salpingectomy was performed.