Published: 2021-09-27

A second trimester live tubal ectopic pregnancy: a case report

Kiran Kunwar, Megha Punetha, Geeta Jain


Ectopic or extra-uterine pregnancy occurs most commonly in fallopian tube. High index of suspicion is key to diagnose ectopic pregnancy in a pregnant-women presenting in first trimester with complains of amenorrhoea, pain in lower abdomen and vaginal bleeding. Such pregnancy can be managed by expectant, medically with methotrexate or surgically via laparoscopy or laparotomy if diagnosed promptly. In this case study, a 36-years-old, G2P1+0 presented in second trimester of pregnancy with pain in lower abdomen and vaginal bleeding. Her vitals were unstable and abdomen tender on palpation. Urgent ultrasound was done suggestive empty uterine cavity, a live 13 weeks 6 days fetus in left adnexa and hemoperitoneum suggestive ruptured tubal ectopic pregnancy. The patient’s final diagnosis was live 13 weeks 6 days ruptured left tubal ectopic pregnancy which was managed by emergency laparotomy with a salpingectomy.


Ectopic pregnancy, Ruptured tubal ectopic pregnancy, Hemoperitoneum

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Bouyer J, Coste J, Fernandez H, Pouly JL, Spira N. Sites of ectopic pregnancy: a 10 year population-based study of 1800 cases. Hum Reprod. 2002;17(12):3224-30.

Taran FA, Kagan KO, Hubner M, Hoopmann M, Wallwiener D, Brucker S. The Diagnosis and Treatment of Ectopic Pregnancy. Dtsch Arztebl Int. 2015;112(41):693-703.

Khalil MM, Shazly SM, Badran EY. An advanced second trimester tubal pregnancy: case report. Middle East Fertil Soc J. 2012;17:136-8.

Barnhart KT, Sammel MD, Gracia CR, Chittams J, Hummel AC, Shaunik A. Risk factors for ectopic pregnancy in women with symptomatic first-trimester pregnancies. Fertil Steril. 2006;86(1):36-43.

Gaskins AJ, Missmer SA, Edwards JW, Williams PL, Souter I, Chavarro JE. Demographic, lifestyle, and reproductive risk factors for ectopic pregnancy. Fertil Steril. 2018;110(7):1328-37.

American College of Obstetricians and Gynecologists. ACOG Practice Bulletin No. 94: Medical management of ectopic pregnancy. Obstet Gynecol. 2008;111(6):1479-85.

Alsuleiman SA, Grimes EM. Ectopic pregnancy: a review of 147 cases. J Reprod Med. 1982;27(2):101-6.

Senterman M, Jibodh R, Tulandi T. Histopathologic study of ampullary and isthmic tubal ectopic pregnancy. Am J Obstet Gynecol. 1988;159(4):939-41.

Budowick M, Johnson TR, Genadry R, Parmley TH, Woodruff JD. The histopathology of the developing tubal ectopic pregnancy. Fertil Steril. 1980;34(2):169-71.

Dietl J, Buchholz F, Kindler PA. Histopathology of tubal pregnancy. Int J Gynaecol Obstet. 1988;27(3):385-8.