Chronic interstitial ectopic pregnancy presenting with a negative urine pregnancy test

BMJ Case Rep. 2024 Apr 8;17(4):e259267. doi: 10.1136/bcr-2023-259267.

Abstract

The ampulla portion of the fallopian tube is the most common site of ectopic pregnancy (70%), with approximately 2% of pregnancies implanted in the interstitial portion. In general, an interstitial ectopic pregnancy (IEP) is difficult to diagnose and is associated with a high rate of complications-most patients with an IEP present with severe abdominal pain and haemorrhagic shock due to an ectopic rupture. Chronic tubal pregnancy (CTP) is an uncommon condition with an incidence of 20%. The CTP has a longer clinical course and a negative or low level of serum beta-human chorionic gonadotropin due to perished chorionic villi. This study presents a case of a woman who was diagnosed with a chronic IEP (CIEP) which was successfully treated by surgery. This case also acts as a cautionary reminder of considering a CIEP in women of reproductive age presenting with amenorrhea, vaginal bleeding and a negative pregnancy test.

Keywords: Ectopic pregnancy; Pregnancy, Ectopic.

Publication types

  • Case Reports

MeSH terms

  • Abdominal Pain / complications
  • Chorionic Gonadotropin, beta Subunit, Human
  • Fallopian Tubes / surgery
  • Female
  • Humans
  • Pregnancy
  • Pregnancy Tests*
  • Pregnancy, Ectopic* / diagnosis
  • Pregnancy, Ectopic* / surgery
  • Pregnancy, Tubal* / diagnosis
  • Pregnancy, Tubal* / surgery

Substances

  • Chorionic Gonadotropin, beta Subunit, Human