Case History

Patient: Female, 34 years old.

Chief Complaint:

Admitted at 13:46 on December 15, 2025, due to 51 days of amenorrhea and 1 day of ectopic pregnancy indicated by B-ultrasound.

Present History:

The patient had regular menstrual cycles: menarche at 13, menstrual duration 3–4 days, cycle length 30 days, moderate menstrual flow (10 sanitary pads per month, approximately 1/3 saturated each), no dysmenorrhea. LMP: October 25, 2025; PMP: September 25, 2025.

Urine HCG test was positive on December 13, 2025, with occasional mild lower abdominal pain and no vaginal bleeding. Due to fertility desire, she visited our hospital on December 15, 2025.

Transvaginal 3D B-ultrasound showed:

Mixed echo mass lateral to the left uterine cornua, suggestive of left interstitial pregnancy with viable fetus, approximately 7 weeks.
Multiple cervical Nabothian cysts.
Small amount of pelvic effusion.
She was hospitalized with a preliminary diagnosis of ectopic pregnancy.
Since onset, no dizziness or fatigue; diet, sleep, mental state, bowel and bladder functions normal; no significant weight change. Height 150 cm, weight 46 kg, BMI 19.9 kg/m².

Past History:

No history of diseases or infectious diseases. No cardiovascular, cerebrovascular, pulmonary, renal, or endocrine disorders. Vaccination history: unknown. No allergies, no trauma.

Surgery and transfusion history: Laparoscopic left salpingectomy for ruptured left ampullary tubal pregnancy on October 16, 2023, in our department; intraoperative bleeding 1000 ml, transfusion of 3 U suspended red blood cells without adverse reactions.

Obstetric and Gynecologic History:

Married, gravida 1, para 0, abortion 3, living 1 (2 induced abortions, 1 induction of labor at 5 months of gestation, 1 vaginal delivery of a female infant in 2013); no contraception.

Family History:

One elder brother healthy; father and mother healthy.

Physical Examination:

Temperature 36.1℃, pulse 78 beats/min, respiration 17 breaths/min, blood pressure 98/69 mmHg, random blood glucose 4.3 mmol/L. General condition good; no obvious abnormalities in heart and lungs. Abdomen flat and soft, no tenderness or rebound tenderness; no edema of both lower extremities.

Gynecological examination: Vulva normal development; vagina unobstructed; cervix smooth, no tenderness on motion; uterus anteverted, full, enlarged to 2 months of gestation, mobile, non-tender; left adnexal region slightly thickened with mild tenderness; right adnexal region unremarkable.

Auxiliary Examinations:

Transvaginal 2D B-ultrasound in our hospital on December 15, 2025, showed:

Mixed echo mass lateral to the left uterine cornua, suggestive of left interstitial pregnancy with viable fetus, approximately 7 weeks.
Multiple cervical Nabothian cysts.
Small amount of pelvic effusion.

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Preliminary Diagnosis:

Amenorrhea to be investigated: left interstitial tubal pregnancy?
Intra-abdominal hemorrhage.
Pregnancy approximately 7 weeks.
Status post left salpingectomy.

Surgical Information

Surgical Procedure: Laparoscopic resection of interstitial tubal pregnancy.

Preoperative serum hCG: 90406.00 IU/L.

Serum hCG at 24 hours postoperatively: 15783.00 IU/L.

Surgeon Introduction

Lian Yangyang

Attending Physician, Master’s Degree, Master’s Supervisor

Certified Physician in Gynecologic Aesthetic Surgery

Selected for the Eagle Talent Program (young and middle-aged professional technical talents) of The Third People's Hospital of Yunnan Province.

Trained at Henan Cancer Hospital.

Specializes in minimally invasive gynecologic surgery and treatment of gynecologic malignant tumors.

Academic Appointments:

Member of the First Fertility Health Care Committee, Yunnan Association of Maternal and Child Health Care

Secretary and Member, Female Pelvic Floor Group, Obstetrics and Gynecology Branch, Yunnan Medical Doctor Association

Member of the Youth Group, First Day Surgery Branch, Yunnan Medical Association

Research Interests:

Drug resistance mechanism of ovarian cancer; endometriosis and its associated ovarian carcinogenesis.

Academic Achievements:

Presided over 1 project of Yunnan Provincial Science and Technology Department (completed).

Presided over 1 hospital-level project (ongoing).

Participated in 6 hospital-level research projects (ongoing).

Published 8 academic papers.

Awards:

Recipient of Excellent Instructor of Dali University (multiple times), Hospital-level Excellent Teacher, Outstanding Communist Party Member.

Second Prize, 2024 Teaching Ability Competition, Chuxiong Medical College.

Second Prize (Individual), Cervical Cancer Prevention and Treatment, 2023 Yunnan Maternal and Child Health Vocational Skills Competition.

Editor: Qing Huan

Reviewer: Ma Ye