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This is an ultrasound of the pelvis in a

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patient with a positive home pregnancy test

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presenting with right-sided pelvic pain.

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This is a sagittal view of the uterus.

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We can see a small amount of the myometrium

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out here and endometrial cavity here.

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We're up near the level of the uterine fundus.

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Adjacent to the uterus and really extending

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outward from the uterus, we see a well

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circumscribed hyperechoic structure with

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central anechoic fluid and a fetal pole.

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We can also see a hyperechoic line extending

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from the endometrium toward this gestational sac

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in the right upper lateral aspect of the uterus.

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This is known as the interstitial line

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sign, and it is a feature that may help you

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identify an interstitial ectopic pregnancy.

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These are additional images through the

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uterus where we can see an empty endometrial

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cavity with surrounding myometrium, and then

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a claw of uterine tissue surrounding this

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gestational sac and early chorion, again

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with a fetal pole visualized internally.

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Crown-rump length of the embryo demonstrates an

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estimated gestational age of 8 weeks and 6 days.

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An M mode evaluation of the embryo

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demonstrates positive cardiac activity

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with a heart rate of 185 beats per minute.

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Additionally, within the eccentrically located

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gestational sac, in the right superior lateral

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aspect of the uterus, we see a yolk sac.

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Both the right and left ovaries are identified

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on this study and are normal in appearance.

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Ultrasound evaluation of the upper

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abdominal quadrants demonstrates a

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small amount of free fluid interposed

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between the liver and the right kidney.

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Again in this case, we see an eccentrically

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located gestational sac within the

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periphery of the uterus along the right

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lateral aspect of the uterine fundus.

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On earlier images, we demonstrated

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an interstitial line sign.

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An evaluation of the embryo

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demonstrated positive cardiac activity.

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This was a surgically confirmed case of

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viable interstitial ectopic pregnancy.