A 26-year-old female pres...

A 26-year-old female presented on the morning of 26/04/23 with complaints of lower abdominal pain. She is a primigravida, currently at 1 month and 11 days of amenorrhea, confirmed by a positive pregnancy test. Her obstetric history includes an abortion about 1 year and 2 months ago. The last menstrual period (LMP) was on 15/03/23, with an estimated due date (EDD) of 22/12/23. Her past medical history is unremarkable, with no history of hypertension, diabetes, thyroid disorders, convulsions, asthma, jaundice, drug allergies, or bleeding disorders. She has not undergone any major or minor surgical procedures in the past. Upon examination, the patient's vital signs were within the normal range, and the abdominal examination revealed no tenderness. Pelvic and vaginal examinations were conducted, indicating uterine and adnexal findings. An ultrasound conducted on 26/04/23 showed an anteverted uterus with a normal endometrial echo reflectivity. A gestational sac was noted in the right adnexa, suggesting a possible ectopic pregnancy and beta-HCG correlation was advised. Cardiac activity was present. Additionally, right-sided forniceal tenderness was observed. Laboratory investigations on the same date showed a serum Beta-HCG level of 3199.81 mIU/ml, while other test results were within normal limits. The patient was diagnosed with an unruptured right-sided ectopic pregnancy and underwent a laparoscopy followed by exploratory laparotomy on 27/04/23. During the procedure, dense adhesions were noted over both fallopian tubes due to omental adhesions, resulting in impaired visualization of the fimbriae. It was decided to perform a laparotomy due to the adhesions, and the right fallopian tube appeared bluish, edematous, and congested at the fimbrial end. The left fallopian tube had flimsy adhesions adhering to the ovary and small intestine. Both ovaries were found to be normal. An inclusion cyst near the left-side fallopian tube was aspirated and sent for histopathological examination. Products of conception were identified and sent for histopathological examination. Hemostasis was adequately achieved, and the post-operative serum Beta-HCG on 29/04/23 was 604.3 mIU/ml. The histopathological examination revealed an ectopic product of gestation in the right fallopian tube and a paratubal cyst. A follow-up ultrasound on 03/05/23 showed no abnormalities in the uterus or adnexa.