title: Rupture of ectopic pregnancy with negative serum beta-hCG leading to hemorrhagic shock.
abstract: 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.
authors.affiliation: 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.
authors.forename: Michael
authors.initials: M
authors.lastname: Grynberg
authors.forename: Jacques
authors.initials: J
authors.lastname: Teyssedre
authors.forename: Caroline
authors.initials: C
authors.lastname: Andre
authors.forename: Olivier
authors.initials: O
authors.lastname: Graesslin
mesh_terms: 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*
chemical_list: D018997:Chorionic Gonadotropin, beta Subunit, Human