Rare Ectopic Pregnancies, Cases, Confusions, and Clues

Ectopic pregnancies are implanted outside the normal location within the uterus; mostly (about 95%) within the fallopian tube but might also rarely be seen within abnormal locations in the uterus, in the ovaries, peritoneal cavity, or even retroperitoneally. These pregnancies are particularly challenging to diagnose. The outcome in most ectopic pregnancies is guarded unless an early diagnosis is made and dealt with by an experienced multidisciplinary team. The management of rare ectopic pregnancies is further complicated by difficulties in diagnosis, delay in diagnosis, and greater risk of bleeding. This paper describes the rare ectopic pregnancies that the authors have seen in their practice, the presentation, pitfalls in diagnosis, the clues that might lead to the correct diagnosis, and the outcomes in these cases are discussed. An algorithmic approach is presented that might improve the diagnostic accuracy.