Intramyometrial gestation: A rare localization of ectopic pregnancy

Intramyometrial pregnancy is the rarest subtype of ectopic pregnancy. It poses a diagnostic and therapeutic challenge. Preoperative diagnosis is difficult, and hysterectomy is always required due to the delay in diagnosis. Misdiagnosis can lead to uterine rupture with life threatening hemorrhage. We report a rare case of intramyometrial ectopic pregnancy in a 27‑year‑old lady, P3L3, with no history of previous abortions. The patient was admitted at 8 weeks of gestation with pelvic pain and hemorrhage. She underwent ultrasound and magnetic resonance imaging scans of the pelvis which revealed an intramyometrial ectopic. Findings on diagnostic laparoscopy revealed an asymmetrically enlarged anterior wall of the uterus. Hysteroscopy was performed concurrently demonstrating an empty uterine cavity. Medical management was adopted with methotrexate. She was followed up until the beta‑HCG levels returned to the baseline. This case report illustrates the imaging findings of an exceptional case of intramyometrial ectopic pregnancy.Key words: Intramyometrial ectopic; magnetic resonance imaging; methotrexate; ultrasound