doiSerbia

Ruptured corpus luteum cyst in early pregnancy: A case report

Vidaković Snežana (Klinički centar Srbije, Klinika za ginekologiju i akušerstvo, Beograd + Medicinski fakultet, Beograd)
Dokić Milan (Klinički centar Srbije, Klinika za ginekologiju i akušerstvo, Beograd + Medicinski fakultet, Beograd)
Vilendečić Zoran (Klinički centar Srbije, Klinika za ginekologiju i akušerstvo, Beograd)
Đakonović-Maravić Maja (Klinički centar Srbije, Klinika za ginekologiju i akušerstvo, Beograd)

Introduction. Transvaginal sonography and human chorionic gonadotropin (hCG) testing are cornerstones of modern clinical practice in cases with the suspected ectopic pregnancy. In unclear cases, if the level of hCG is above the discriminatory zones, the use of uterine curettage is recommended. There is an increasing concern that strict observation of the guidelines would potentially harm otherwise normal early intrauterine pregnancies in certain cases. Case Outline. A 35-year-old woman was admitted to hospital due to a severe lower abdominal pain. Based on the positive pregnancy test and sonographic exams which failed to demonstrate intrauterine pregnancy, the diagnosis of ectopic pregnancy was presumed. Laparoscopy revealed ruptured corpus luteum cyst and the diagnosis was confirmed on histopathological finding. Postoperatively, normal intrauterine gestation was visualized. Conclusion. Since the diagnosis of early pregnancy and its complications can be misleading, in unclear cases, we support the expectative “wait and see” management consisting of serial hCG testing and repeated ultrasound examinations. Avoidance of uterine curettage in such unclear cases would further reduce the possibility of normal early pregnancy interruption.

Keywords: pregnancy of unknown location, human chorionic gonadotropin, discriminatory zone, ectopic pregnancy, transvaginal ultrasonography