PMC5780312_01
PMC5780312_02
Ultrasound finding at the fist evaluation at emergency room. (A) the anti-verted empty uterus; (B) a rounded image with hyperechoic boundaries, suggestive of fetal head in the upper right side of abdomen; (C) a normal right ovary of 32x13 mm; (D) a left adnexa with a hyperechoic mass of 68x56 mm, with not univocal interpretation.
ogs-61-154-g001.jpg
PMC5780312_02_ogs-61-154-g001.jpg
F1
At vaginal and abdominal ultrasound examination (Fig. 1), we saw an anti-verted uterus of 97x57 mm, with decidual reaction, a left adnexa with a hyperechoic mass of 68x56 mm, with no univocal interpretation and a normal right ovary of 32x13 mm.
Fetal connection to left fallopian tube, site of placental implantation.
ogs-61-154-g002.jpg
PMC5780312_02_ogs-61-154-g002.jpg
F2
The anti-mesial surface showed continuous dripping, so we removed the enlarged tube with the fetus connected by the umbilical cord (Fig. 2).
Macroscopic cut to the suspected site of placental implantation, to confirm placenta presence.
ogs-61-154-g003.jpg
PMC5780312_02_ogs-61-154-g003.jpg
F3
An intraoperative macroscopic examination, after a longitudinal left tube cut, confirmed our hypothesis: the placenta was located into the adnexa (Fig. 3).