Rupture of ectopic pregnancy with negative serum beta-hCG leading to hemorrhagic shock.
BACKGROUND
Rupture of a fallopian tube caused by ectopic pregnancy may have serious consequences including hemorrhagic shock. The diagnosis of ectopic pregnancy is based on the demonstration of pregnancy using serum beta-hCG assays. Thus, a negative test usually allows the exclusion of the diagnosis of ectopic pregnancy.


METHODS
We present an unusual case of ectopic pregnancy resulting in hemorrhagic shock despite negative results for serum beta-hCG tests. Computed tomography and ultrasound scans revealed hemoperitoneum and a right adnexal mass. Medical management and laparoscopic salpingectomy allowed for a favorable outcome.


CONCLUSIONS
This case illustrates the potential for an ectopic pregnancy to rupture with undetectable serum beta-hCG levels. Further, it illustrates the helpful role of imaging exams in diagnosing a patient with unstable hemodynamic status.
Grynberg
Michael
M
From the CHU Reims, Institut mère-enfant Alix de Champagne, Service de gynécologie-Obstétrique, and the Institut Jean Godinot, Service d'anatomie pathologique, Reims, France.
Teyssedre
Jacques
J
Andre
Caroline
C
Graesslin
Olivier
O
D000328:Adult; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000097:blood*; D005187:Fallopian Tubes / Q000601:surgery; D005260:Female; D006465:Hemoperitoneum / Q000209:etiology; D006801:Humans; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000097:blood* / Q000175:diagnosis* / Q000601:surgery; D012771:Shock, Hemorrhagic / Q000209:etiology*
D018997:Chorionic Gonadotropin, beta Subunit, Human