Intramural pregnancy is a rare form of ectopic pregnancy with early diagnosis
essential for prevention of severe hemorrhage and uterine rupture. We report a
rare case of an intramural ectopic pregnancy at 12 weeks gestation in a woman 1
year post open myomectomy. Both transvaginal ultrasound and magnetic resonance
imaging were utilized as diagnostic aids in this case. The rare nature of this
clinical scenario and lack of guidelines for management made clinical decision
making difficult. Due to the size and location of the gestational sac,
hysterectomy was deemed to be the safest modality, and a midline laparotomy,
total abdominal hysterectomy, and bilateral salpingectomy was performed.