Chronic ectopic pregnancy: case report and systematic review of the literature

Caesarean scar ectopic pregnancy masquerading as gestational trophoblastic disease

“…[ 1 ] Chronic ectopic pregnancy is a rare variant of ectopic pregnancy, characterized by low or absent levels of serum hCG and methotrexate resistance. [ 2 ] CSEP (incidence being 6.1%) occurs when the implantation of the blastocyst occurs on a previous cesarean scar,[ 3 ] with the first case of CSEP reported in 1978. [ 4 ] Although a rare location for ectopic pregnancy, its incidence is increasing all over the world due to an increase in cesarean section deliveries.…”

A rare presentation of chronic ovarian ectopic pregnancy: A case report

“…It usually has a prolonged and indolent clinical course and may even resolve spontaneously. In a recent review 7 in which 19 case reports, 3 case‐control studies, and 3 case series describing 399 patients with CEP were included, serum hCG was negative in 40/124 cases (32%) with reported levels of serum hCG.…”

Case of a chronic ectopic pregnancy misdiagnosed as pelvic inflammatory disease

“…The definition of a chronic ectopic pregnancy (CEP) is ill defined in the literature, however, it is usually an ectopic pregnancy presenting with gradual tubal wall disintegration with repeated episodes of haemorrhaging. This results in the formation of a complex pelvic mass 3. CEP is thought to account for 6% of all ectopic pregnancies 4.…”

“…CEP is thought to account for 6% of all ectopic pregnancies 4. According to a systematic review of 399 patients, the most common presenting symptom in women with CEP is abdominal pain (71%), followed by irregular vaginal bleeding (55%) and fever (5%) 3. An asymptomatic presentation is found in 18% of cases 3…”

“…This may in turn promote an inflammatory reaction giving rise to adhesions and therefore a complex adnexal mass 4. The use of transvaginal ultrasound scanning is partially sensitive in the diagnosis of CEP as this can be seen in 48% of cases 3. However, it is not specific as several alternative diagnoses can give rise to a sonographic appearance of a non-homogeneous adnexal mass 5.…”