PMC9039427_01
Transvaginal pelvic ultrasound transverse and sagittal images of right and left ovaries demonstrating enlarged ovaries with multiple sub-centimeter peripheral cysts.
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A 27-year-old, Gravida 2 para 0 + 1, with polycystic ovarian disease (Figure 1) on Metformin and Pioglitazone for 4 years came to our facility with amenorrhea for 6 weeks.
Trans-abdominal pelvic ultrasound at 5 weeks and 5 days which shows an intrauterine gestation sac without yolk sac or fetal poles marked with (*) and normal adnexa as well as no free fluid in the pelvis.
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Trans-abdominal ultrasound was performed, and an intrauterine gestation sac was detected with mean sac volume corresponding to 5 weeks and 5 days without yolk sac or fetal poles and hence advised follow-up ultrasound after 2 weeks to assess fetal viability (Figure 2).
Transvaginal pelvic ultrasound images revealing live intrauterine and extra uterine gestations on the right and left images, respectively.
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In addition, an unruptured extra uterine gestational sac was found in the right adnexa with gestational age corresponding to 8 weeks, with cardiac activity seen and fetal heart rate of 146 beats/min (Figure 3).
Laparoscopy image demonstrating the right adnexal gestation sac with a fetus within marked with (*).
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She then underwent emergency exploratory laparoscopy, which revealed a slow leaking ectopic pregnancy with intact gestational sac seen in the right ampullary region of the fallopian tube (Figure 4).
Transvaginal pelvic ultrasound 1-week post laparoscopic salpingectomy reveals live intrauterine gestation.
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Follow-up ultrasound which was taken 6 days post operation showed an 8 week and 5-day fetus with fetal poles, and fetal heart rate of 171 bpm (Figure 5).