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Rectal ectopic pregnancy after in vitro fertilization and embryo transfer: A case report
Chujun Wang1, Yipin Xiong, Fengzhen Liu
1Department of Ultrasound, The Second Affiliated Hospital of Nanchang University, Nanchang, China.
Rationale:
Rectal ectopic pregnancy is an extremely rare abdominal pregnancy. This article presents a female underwent an unsuccessful in vitro fertilization which was misdiagnosed by serum beta-human chorionic gonadotropin (β-hCG) test and transvaginal ultrasonography. Twenty days later, a ruptured rectal ectopic pregnancy was confirmed by laparoscopy then the gestational tissue removed successfully.
Patient Concerns:
A 32-year-old Chinese female was admitted to our hospital with complaining of symptoms, like gradual worsening of lower abdominal pain and dysuria. The abdominal ultrasonography revealed a sac-like mass in the posterior area to the uterus and a moderate amount of free fluid in the pelvic cavity. Forty days ago, she underwent a frozen embryo transfer. Twenty days ago, her serum β-hCG level was <5 mIU/mL and neither intrauterine nor ectopic pregnancy was detected by transvaginal ultrasonography. Then the procedure was thought to have resulted in biochemical pregnancy failure.
Diagnosis:
The primary rectal ectopic pregnancy.
Interventions:
The mass was removed laparoscopic surgery.
Outcomes:
The patient recovered well.
Lessons:
When the history of in vitro fertilization combined with an inappropriate rise of serum β-hCG and no visible evidence of an intra-uterine pregnancy, physicians should consider the possibility of abdominal pregnancy. Early diagnosis of abdominal pregnancy can effectively save the life of the pregnant woman.
