title: Ruptured ectopic pregnancy with a negative urine pregnancy test.
abstract: Ectopic pregnancy is commonly seen as a differential diagnosis of first-trimester vaginal bleeding. Often the diagnosis is made based on a combination of exam findings, transvaginal ultrasound, and a positive pregnancy test. Our case describes a patient with a history of ectopic pregnancy treated with methotrexate and serial human chorionic gonadotropin measurements that were decreasing appropriately. At the time of evaluation, her urine pregnancy test was negative; however, she was confirmed to have a ruptured tubal ectopic pregnancy. This case highlights the variable presentation of ectopic pregnancies and the importance of combining exam findings with ultrasound and laboratory results.
authors.affiliation: Department of Obstetrics and Gynecology, Baylor University Medical Center at Dallas (Hughes, Browning), and Texas A&M Health Science Center College of Medicine (Lupo), Dallas, Texas.
authors.forename: Mallory
authors.initials: M
authors.lastname: Hughes
authors.affiliation: Department of Obstetrics and Gynecology, Baylor University Medical Center at Dallas (Hughes, Browning), and Texas A&M Health Science Center College of Medicine (Lupo), Dallas, Texas.
authors.forename: Andrew
authors.initials: A
authors.lastname: Lupo
authors.affiliation: Department of Obstetrics and Gynecology, Baylor University Medical Center at Dallas (Hughes, Browning), and Texas A&M Health Science Center College of Medicine (Lupo), Dallas, Texas.
authors.forename: Adrianne
authors.initials: A
authors.lastname: Browning