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Case Reports in Obstetrics and Gynecology
Volume 2012 (2012), Article ID 213169, 3 pages
http://dx.doi.org/10.1155/2012/213169
Case Report

Rupture of Ovarian Pregnancy in a Woman with Low Beta-hCG Levels

Department of Obstetrics, Gynaecology and Urology, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, Italy

Received 24 September 2012; Accepted 23 October 2012

Academic Editors: A. Ohkuchi and S. Salhan

Copyright © 2012 Serena Resta et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Ovarian pregnancy is a rare form of ectopic pregnancy. It is often difficult to distinguish from tubal pregnancy, and diagnosis and management are frequently a challenge. Case. A 33-year-old nulligravida woman presented with light vaginal bleeding and bilateral lower quadrants abdominal pain. Beta-human chorionic gonadotropin (beta-hCG) level (592 mUI/mL) and clinical and ultrasound (US) findings were suspicious for tubal pregnancy. On the third day, despite beta-hCG decrease (364 mUI/mL), she complained of severe pain in the lower abdomen, and physical examination revealed abdominal rebound tenderness. US showed a large amount of fluid in the abdominal cavity. Because of the unstable clinical condition, emergency laparoscopy and resection of left ovarian ectopic pregnancy were performed. Histology confirmed ovarian gestation. Conclusion. This case shows that ectopic pregnancy rupture may occur despite low levels of beta-hCG. Hemoperitoneum is not contraindication to laparoscopy.