April Ultrasound Case

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A 21yo woman without PMH, G2P1, ~15 weeks pregnant presented with abdominal pain and mild vaginal bleeding. One week prior she had presented for abdominal pain and per her report had a “confirmed IUP” at another ER.

 Notable exam:

Afebrile, HR: 75, BP: 105/60, RR: 18, POx: 100%

Abd: Moderate RLQ TTP, no peritoneal signs

GYN: mild vaginal bleeding in vault, os closed, right adnexal TTP

 B-HCG: 7,000

Hct: 34

UA: negative

Click here to view the patient’s ultrasound photos 

What does this patient need now? What is the disposition?

3 Comments

  • Derreck

    That is exactly what the team was thinking, and did!

    The patient was rescuscitated with NS IVF, type and crossed, and placed on a monitor. Preop labs were collected. GYN was consulted for concern of a possible ectopic pregnancy.

    In the OR, there was NOT an ectopic pregnancy found. Instead it was a contained hemorrhagic cystic ovary. The ovary was not removed and the patient was determined to have a concurrent hemorrhagic ovary with a completed AB. She did well post-op.

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