Interstitial ectopic pregnancy presenting after failed termination of pregnancy

Pregnant women frequently present to the ED for complaints related to the first trimester of pregnancy. The emergency physician must confirm the presence of an intrauterine pregnancy for many such complaints. Bedside ultrasound with well-delineated criteria has become standard practice for many emergency physicians for this purpose. In the following case report, an interstitial pregnancy was identified by the emergency physician using bedside sonography in a 29-year-old woman presenting 2 weeks after dilation and aspiration for termination of pregnancy. The ED physician identified an inappropriately thin endomyometrial mantle raising suspicion for the diagnosis of an interstitial pregnancy. The case illustrates the importance of this uterine wall measurement given the otherwise normal appearance of a pregnancy within the uterus.