Citing a real case here
A 24 year old woman, came to OPD for consultation for Abortion tablets
-She had a living female child of 2.5 years of age by normal delivery ( G-2,P-1,L-1).
-She had missed her menses and her UPT- Urine Pregnancy Test was positive and she was not desirous of continuing this pregnancy as this child is not yet school going.
-She has been complaining of on & off menstrual like lower abdomen cramps, which on some moments were severe.
-But she did not start with menses.
-On examination- her lower abdomen was slightly distended.
- Pulse rate was 92/min and BP- 100/70 mm Hg
- As a routine test and precaution before giving abortion pills, Trans-Vaginal ultrasound was performed.
-The findings suggested intra-abdominal free fluid amounting to 700-800 ml
-There was G-Sac ( Gestational sac ) like structure near left ovary which was surrounded by a mass of tissue , which seemed to be attached to left ovary.
-Diagnosis of Ovarian ruptured ectopic pregnancy was suspected as there was a breach in the outer lining of ovary too and adnexal mass was lying just close to that, along with echogenic mass lesion in the ovary (Trophoblastic Tissue).
- She was immediately posted for Laparoscopy .
- On putting the scope, the first finding that we noted was Haemoperitoneum ( Blood in peritoneal cavity)
- Upon suctioning and cleaning it up, it was then possible to locate ruptured Left ovarian ruptured ectopic pregnancy.
- Mass lesion was resected ( surgically cut ) and Haemostasis ( There is no longer bleeding ) was achieved.
- She required one unit of packed cells blood transfusion intra-operatively and her recovery post operatively was uneventful.
-Following routine safety protocols, timely intervention and availability of blood products saved the life of the woman