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Obstetrics » Obstetrics 1st Trimester
Bilateral ectopic pregnancy
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Author(s) :
Gopal Surendran, MD
Presentation This is the scan in a patient with bilateral tubo-ovarian masses and pain in the abdomen. Her past history was significant for an operated ruptured ectopic 2 years ago. Her current Beta-HCG levels are high.
Caption: Transverse transvaginal scan
Description: The uterus appears normal. Bilateral tubo-ovarian masses are noted in the adnexae as labeled.
Caption: Magnified view of the right adnexal mass
Description: An ectopic gestational sac with the embryo is seen in the right adnexa. The sac is surrounded by a thick echogenic rim.
Caption: Color Doppler scan of the right adnexal mass
Description: The ring of fire sign is seen surrounding the ectopic gestational sac.
Caption: Color Doppler scan of the left adnexal mass
Description: An ectopic gestational sac with thick echogenic rim is noted in the left adnexa. Increased vascularity is noted in the ring surrounding the sac.
Differential Diagnosis

Bilateral ectopic pregnancy

Final Diagnosis Bilateral ectopic pregnancy
Follow Up Ultrasound guided salpingocentesis was performed and methotrexate was injected into both the sacs. The Beta HCG levels subsequently dropped.
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