Intramurale Schwangerschaft - Ein Fallbericht mit Literaturübersicht

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 abdominal pain. Prior transvaginal sonography revealed an apparently normal intrauterine pregnancy. Due to increasing symptoms and free intraabdominal fluid several hours later, laparoscopy was performed, but the source of bleeding could only be identified as a ruptured intramural pregnancy at laparotomy. Intramural pregnancy is the rarest form of ectopic pregnancies. Only 31 cases are found in the literature. The clinical diagnosis is difficult, only one case diagnosed preoperatively is known. The etiology is still discussed and unknown, although it seems that prior trauma of the uterus may play a role. To the best of our knowledge this is the first case of intramural pregnancy associated with an intrauterine device.