Case Report of an Undisturbed Ectopic Pregnancy with Very High Human Chorionic Gonadotrophin (β-hCG)

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