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Case report
Unexpected rupture of an expectantly managed tubal ectopic pregnancy: a reminder for enhanced diligence
  1. Amenda Ann Davis,
  2. Kusum Lata,
  3. Akshita Panwar and
  4. Alka Kriplani
  1. Obstetrics and Gynaecology, Paras Hospitals, Gurgaon, Haryana, India
  1. Correspondence to Dr Amenda Ann Davis; davis.amenda{at}


Expectant management of tubal ectopic pregnancies is a feasible and possibly preferable method of management in asymptomatic women with low serum β-human chorionic gonadotropin (hCG). This involves serial monitoring of β-hCG until negative, after which it is deemed as spontaneously resolved ectopic pregnancy. We describe a case of tubal ectopic pregnancy which was expectantly managed with an initial β-hCG of 585 mIU/mL until undetectable. This patient presented with ruptured ectopic pregnancy 8 weeks after the original diagnosis, at the level of 5 mIU/mL. This highlights the importance of close monitoring in the expectant management of tubal ectopic pregnancies, with the incorporation of imaging, even when serial β-hCG shows a persistently reducing trend.

  • pregnancy
  • obstetrics and gynaecology

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  • Contributors AAD drafted the article and did review of literature. KB conceived and designed the manuscript. AP was involved in acquisition and interpretation of patient’s clinical data. AK gave final approval of the version published. All authors agree to be accountable for the article and to ensure that all questions regarding the accuracy or integrity of the article are investigated and resolved.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.