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Rupture of ectopic pregnancy with negative serum beta-hCG leading to hemorrhagic shock
Michael Grynberg1, Jacques Teyssedre, Caroline Andre
1From the CHU Reims, Institut mère-enfant Alix de Champagne, Service de gynécologie-Obstétrique, and the Institut Jean Godinot, Service d'anatomie pathologique, Reims, France.
Background:
Rupture of a fallopian tube caused by ectopic pregnancy may have serious consequences including hemorrhagic shock. The diagnosis of ectopic pregnancy is based on the demonstration of pregnancy using serum beta-hCG assays. Thus, a negative test usually allows the exclusion of the diagnosis of ectopic pregnancy.
Case:
We present an unusual case of ectopic pregnancy resulting in hemorrhagic shock despite negative results for serum beta-hCG tests. Computed tomography and ultrasound scans revealed hemoperitoneum and a right adnexal mass. Medical management and laparoscopic salpingectomy allowed for a favorable outcome.
Conclusion:
This case illustrates the potential for an ectopic pregnancy to rupture with undetectable serum beta-hCG levels. Further, it illustrates the helpful role of imaging exams in diagnosing a patient with unstable hemodynamic status.
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