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Background: Majority of the reports suggest that the frequency of ectopic pregnancies have grown in the last 30 years, especially in patients conceived through artificial reproductive techniques (ART). To prevent severe morbidity and mortality its prompt diagnosis and appropriate management is important. In a select patient population, most of the unruptured, live ectopic pregnancies can be successfully managed without surgical intervention using trans-vaginal ultrasound guided aspiration and instillation of local injection KCl or administration of systemic Inj. Methotrexate. Methods: This study is a hospital based retrospective cohort study from January 2014 to December 2022 on patients who presented to Institute of Kidney Diseases and Research Centre (IKDRC) with unruptured ectopic pregnancy confirmed with ultrasound and β HCG. All the patients were analyzed according to history, clinical presentation, investigations, treatment and complications. Results: β-HCG day 1 or 2 post procedure dropped in all cases but in variable levels ranging from 1.3% to 85.88%, while the drop during days 7-10, was more significant and reassuring; ranged from 48.69% to 98.95%. Conclusions: By aspiration of ectopic gestational sac transvaginally under ultrasonographic guidance it is able to preserve the integrity of uterus and fallopian tube and thus the future fertility. The study will educate other healthcare professionals.

Pregnancy luteoma is a rare non-neoplastic tumor-like mass of the ovary. They are usually asymptomatic and found incidentally during ultrasound imaging or surgery. Rarely do they present with pain abdomen mimicking threatened preterm labor. They regress spontaneously after delivery. We presented a case of a 29-year-old G4A3 with twin pregnancies and chronic hypertension who presented with acute flank pain, constipation, and occasional hardening of the uterus. A provisional diagnosis threatened preterm labor with suspected ureteric colic and cystitis was made. The patient was initially managed on the same line but on a detailed in-patient evaluation her ultrasound revealed bilateral multicystic ovaries with few hypoechoic areas inside it mostly suggestive of ‘luteoma of pregnancy’. The patient had acne, hirsutism, and chronic hypertension well controlled on antihypertensives. The patient delivered twins successfully by cesarean section and luteoma and symptoms were resolved postpartum after 4 months. Recognition of this entity is important so that malignancy can be ruled out and unnecessary surgery, with concomitant risk to both the mother and the fetus, is avoided.