PMC2700684_01
On 3-12-07, showing a single intrauterine gestational sac of 8.4 mm corresponding to 5 weeks 4 days, with no yolk sac or fetal pole seen
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TVS after a week on 3-12-07 documented a GS of 8.4 mm = 5 weeks 4 days [Figure 1], with no yolk sac or fetal pole seen. There was minimal tenderness in the right fornix but no ectopic gestational sac (GS) was seen in either fornix [Figure 2].
On 3-12-08, bilateral adnexa normal
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TVS after a week on 3-12-07 documented a GS of 8.4 mm = 5 weeks 4 days [Figure 1], with no yolk sac or fetal pole seen. There was minimal tenderness in the right fornix but no ectopic gestational sac (GS) was seen in either fornix [Figure 2].
(a) On 6-12-07, showing two intrauterine gestational sacs of 10.5 and 4 mm, with no yolk sac or fetal pole seen; (b) On 6-12-07, showing two intrauterine gestational sacs with no yolk sac or fetal pole seen on a three-dimensional scan; (c) Showing two ectopic sacs in the right adnexal region of 4 and 6 mm
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TVS-IU GS [Figure 3a], it was 10.5 mm = 5 weeks 6 days, with no fetal pole or yolk sac seen. There was another second small GS seen measuring 4 mm [Figure 3b], which could be due to fertilization of the oocyte due to delayed ovulation from the follicle that was 16.5 mm on the day of hCG. There were also two small sacs measuring 4 and 6 mm, seen in the right adenexa [Figure 3c], the left adenexa appearing normal, with no free fluid in the pouch of douglas (POD). There was no abdominal tenderness or guarding.
(a) On 8-12-07, showing an intrauterine gestational sac of 10.5 mm with no yolk sac or fetal pole seen; (b) On 8-12-07, two sacs in the right adnexa measuring 8 and 6 mm
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On 8-12-07, the beta hCG was 12,947 mIU/ml, with an IU GS of 10.5 mm = 5 weeks 6 days, with no fetal pole or yolk sac [Figure 4a]. The two sacs in the right adenexa had increased in size to 8 and 6 mm [Figure 4b].
Single intrauterine gestational sac with yolk sac on 20-09-08
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Repeat beta hCG on 20- 09-08 [Figure 5] after 1 week was 15,000 mIU/ml.
Single intrauterine fetus of 10 weeks of gestational age with normal right adnexa on 11-10-08
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The patient was regularly followed-up every 8 days till 12 weeks [Figure 6] in view of her previous ectopic sacs appearing late.