Abstract

A clinical case describing the potential of elastography and three-dimensional echocardiography in tubal pregnancy in a patient who was not initially diagnosed during laparoscopy is presented. The dynamic observation showed an increase in serum chorionic gonadotropin; the postoperative follow-up with elastography and three-dimensional echocardiography revealed signs of initially progressive and subsequently interrupted tubal pregnancy (the patient refused a second laparoscopy). Threedimensional echocardiography contributed to better visualization of the ovum compared to the B-mode image; the sign of tubal pregnancy (a vascular “ring of fire”) was clearly identified in the glass-body mode. A laparoscopic tubal ligation was then performed. The diagnosis was confirmed histologically. Conclusion. Ultrasound elastography and three-dimensional echocardiography contribute to better diagnosis of tubal pregnancy in complicated clinical situations. Key words: tubal pregnancy, ectopic pregnancy, elastography, three-dimensional echocardiography, vascular “ring of fire”

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