Abstract

An interstitial ectopic pregnancy (IEP) is an uncommon form of tubal ectopic pregnancy. IEP frequently results in more maternal complications due to challenges in both diagnosis and management. We present the case of a woman who presented for an early pregnancy ultrasound due to risk factors for ectopic pregnancy. Despite elevated pregnancy hormone bloods a departmental ultrasound by an experienced sonographer did not identify a pregnancy. The presence of a large uterine fibroid made performing and interpreting the ultrasound more challenging. Although the woman was initially well with no symptoms, following an episode of severe pain and signs of intra-abdominal bleeding, emergency surgery was performed. A ruptured IEP was identified and successfully surgically treated via laparoscopy with minimal disruption to the uterus or bleeding. Recovery was uncomplicated. IEP is rare and difficult to diagnose. Diagnosis is even more challenging in the presence of uterine abnormalities such as fibroids. With appropriate expertise, surgical management of a ruptured IEP with a minimalist laparoscopic approach is possible.