Ruptured advanced tubal ectopic pregnancy simulating uterine rupture: a case report.
BACKGROUND
Ectopic pregnancy is one of the most critical and life-threatening emergencies in gynaecological practice and poses a diagnostic dilemma in advanced cases. This report highlights a case of ruptured advanced tubal ectopic pregnancy simulating uterine rupture.


METHODS
Case-note of a patient managed for ruptured advanced tubal ectopic pregnancy was used with a review of the relevant literature.


RESULTS
A 24-year old primigravida who presented at 23 weeks gestation with signs and symptoms suggestive of ectopic pregnancy is presented. The advanced nature of the pregnancy posed a diagnostic dilemma as ruptured uterus shares the same characteristic dramatic presentation, especially in this patient with previous myomectomy. Prompt resuscitation and immediate laparotomy produced a good outcome.


CONCLUSIONS
High index of suspicion is important in the diagnosis of ectopic pregnancy. Even when diagnosis is in doubt, exploratory laparotomy may be life saving.
Department of Obstetrics & Gynaecology, Ebonyi State University Teaching Hospital, Abakaliki, Nigeria.
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Ibekwe
D000328:Adult; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000175:diagnosis*; D012422:Rupture, Spontaneous / Q000175:diagnosis; D014597:Uterine Rupture / Q000175:diagnosis*