A 27 yr old G3P2 presented to the early pregnancy clinic at 6 weeks gestation with lower abdominal pain and mild spotting per vaginum. Her serum βhcg level was 5574 iu/l and Transvaginal Scan (TVS) reported no evidence of intrauterine pregnancy with normal adnexae. The patient was admitted with a diagnosis of PUL and a diagnostic laparoscopy was done. On laparoscopy, there was no evidence of an extrauterine pregnancy and the pelvis was normal. She was then followed up with serial βhcg levels as an outpatient.
A repeat βhcg level in 48hrs was 6096 iu/l. A repeat TVS revealed an endometrial thickness of 14 mm, no intrauterine sac, normal ovaries and small area of mixed echogenicity suggesting possible early pregnancy. She was managed conservatively with monitoring of βhcg levels and ultrasound pelvis. The follow up TVS after a week showed no evidence of Intrauterine Pregnancy (IUP) and…
