فهرست نشریات علمی دسترسی آزاد ایران

Background & aim: About 1 in 100 pregnancies are ectopic pregnancies (EPs), which most commonly occur in the fallopian tube. Most EPs rupture during the first trimester. An objective assessment is required to ensure the diagnosis is not missed or delayed, especially in atypical cases and in resource-limited settings. A strong suspicion of EP should warrant careful ultrasound examination, as some cases are atypical. Case report: We present an unruptured EP at 20 weeks of gestation in a 21-year-old primigravid woman presenting with right lower quadrant pain, managed with a total salpingectomy. The diagnosis was challenging. Despite having two ultrasound reports of an intrauterine pregnancy, the diagnosis of an EP was likely amidst right lower quadrant pain, no palpable uterus, an ultrasound report of probable EP, and failed cervical ripening. Intra-operative findings confirmed a right ampullary pregnancy with the contralateral tube absent. She was counseled on future infertility resulting from the total salpingectomy and provided education on alternatives, including in vitro fertilization. Conclusion: Early diagnosis requires careful clinical judgement, especially when the presentation is atypical, and can prevent complications and salpingectomy. Patients should be educated on the role of first-trimester ultrasound scans in determining the location of pregnancy.