A Case of Ectopic Pregnancy—An Unusual Diagnostic Challenge and Lesson Learnt

Awatuf Elshirif, Seema Sadiq

King’s College Hospital NHS Foundation Trust, Princess Royal University Hospital, London, UK.

DOI: 10.4236/ojog.2015.54027                

Abstract

Ectopic pregnancy has been increasing in frequency over the past 2 decades. The sudden rupture of ectopic pregnancy can lead to haemorrhagic shock and death if not diagnosed and treated in a timely fashion. The first step in the diagnosis of ectopic pregnancy is demonstration of pregnancy by means of a rapidly performed and sensitive qualitative urine test for the beta-subunit of human chorionic gonadotropin (beta-hCG). This case report demonstrates the importance of further consideration of the diagnosis of ectopic pregnancy in the setting of an unusual presentation like per rectal bleed and amenorrhea for three years in the presence of Mirena.

Keywords

Ectopic, Pregnancy, Test, Mirena

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	Murray, H., Baakdah, H., Bardell, T. and Tulandi, T. (2005) Diagnosis and Treatment of Ectopic Pregnancy. CMAJ, 173, 905-912. http://dx.doi.org/10.1503/cmaj.050222
[2]	Tay, J.I., Moore, J. and Walker, J.J. (2000) Ectopic Pregnancy. BMJ, 320, 916-919. http://dx.doi.org/10.1136/bmj.320.7239.916
[3]	Dialani, V. and Levine, D. (2004) Ectopic Pregnancy: A Review. Ultrasound Quarterly, 20, 105-117. http://dx.doi.org/10.1097/00013644-200409000-00005
[4]	Murray, H., Baakdah, H., Bardell, T. and Tulandi, T. (2005) Diagnosis and Treatment of Ectopic Pregnancy. CMAJ, 173, 905-912. http://dx.doi.org/10.1503/cmaj.050222
[5]	Cunningham, F.G., MacDonald, P.C., Gant, N.F., Gilstrap, L.C. and Leveno, K., Eds. (1993) Williams Obstetrics: Ectopic Pregnancy. 19th Edition, Appleton & Lange, East Norwalk (CN), 691-720.
[6]	Aboud, E. and Chaliha, C. (1998) Nine Year Survey of 138 Ectopic Pregnancies. Archives of Gynecology and Obstetrics, 261, 83-87. http://dx.doi.org/10.1007/s004040050204
[7]	Wong, E. and Suat, S.O. (2000) Ectopic Pregnancy: A Diagnostic Challenge in the Emergency Department. European Journal of Emergency Medicine, 7, 189-194. http://dx.doi.org/10.1097/00063110-200009000-00005
[8]	Lozeau, A.M. and Potter, B. (2005) Diagnosis and Management of Ectopic Pregnancy. American Family Physician, 72, 1707-1714.
[9]	Aboud, E. (1997) A 5-Year Review of Ectopic Pregnancy. Clinical & Experimental Obstetrics & Gynecology, 24, 127-129.
[10]	Thomas, L.S. (2002) Ectopic Pregnancy. Top Emerg Med., 24, 12-20.