Intramural pregnancy - A case report and review of literature

We present a case of ruptured intramural pregnancy in a 26-year old gravida 2, para 2, admitted at 14 weeks of gestation with sudden onset of lower ab dominal pain. Prior transvaginal sonography revealed an apparently normal i ntrauterine pregnancy. Due to increasing symptoms and free intraabdominal f luid several hours later, laparoscopy was performed, but the source of blee ding could only be identified as a ruptured intramural pregnancy at laparot omy. Intramural pregnancy is the rarest form of ectopic pregnancies. Only 3 1 cases are found in the literature. The clinical diagnosis is difficult, o nly one case diagnosed preoperatively is known. The etiology is still discu ssed and unknown, although it seems that prior trauma of the uterus may pla y a role. To the best of our knowledge this is the first case of intramural pregnancy associated with an intrauterine device.