# Early Pregnancy with corpus luteum cyst: A Case Study
Ultrasound is a valuable tool for diagnosing and monitoring various conditions in early pregnancy. In this blog post, I will share a case study of a patient who presented with positive pregnancy test at 5 weeks of gestation.
## Case Presentation
The patient was a 28-year-old woman, gravida 2, para 1, who came to the emergency department with mild lower abdominal pain and spotting. She had a history of regular menstrual cycles and no previous pelvic surgery or infection. She had a positive urine pregnancy test at home and estimated her last menstrual period to be 5 weeks ago. She denied any fever, nausea, vomiting, or dysuria.
## Ultrasound Findings:
Corpus luteum cyst:
The patient underwent a transvaginal ultrasound scan, which showed the following findings:
- A live viable intrauterine embryo of 5 weeks, measuring 2 mm in crown-rump length, with a visible cardiac activity of 120 beats per minute. The embryo was located eccentrically within the gestational sac, which measured 10 mm in mean diameter. The yolk sac, which provides nutrition and blood formation to the embryo, was also seen as a small round structure within the gestational sac.
- A right corpus luteum cyst, measuring 15 mm in diameter, with surrounding vascularity. The corpus luteum is a temporary endocrine structure that forms from the ovulated follicle and produces progesterone, which supports the early pregnancy. A corpus luteum cyst is a common finding in the first trimester and usually resolves spontaneously by the second trimester. The vascularity of the corpus luteum cyst indicates its functional status and can be assessed by color Doppler ultrasound.
- No evidence of ectopic pregnancy, which is a life-threatening condition where the embryo implants outside the uterine cavity, most commonly in the fallopian tube. Ectopic pregnancy can present with similar symptoms as normal pregnancy, such as pelvic pain, bleeding, and positive pregnancy test. However, ultrasound can usually differentiate ectopic pregnancy from normal pregnancy by the absence of an intrauterine gestational sac and the presence of an adnexal mass, fluid, or blood in the pelvis. In some cases, ectopic pregnancy can be difficult to diagnose by ultrasound, especially if it is very early or located in an unusual site, such as the cervix, ovary, or abdomen. In such cases, serial measurements of serum beta-human chorionic gonadotropin (beta-hCG) levels and close clinical follow-up are required.
#Prognosis and Management
The patient was diagnosed with a normal intrauterine pregnancy of 5 weeks with a small right corpus luteum cyst. The prognosis of the pregnancy was favorable, as the embryo showed normal growth and cardiac activity. The corpus luteum cyst was benign and did not pose any risk to the pregnancy or the patient. The patient was advised to avoid strenuous activities, sexual intercourse, and non-steroidal anti-inflammatory drugs (NSAIDs). She was also prescribed oral progesterone supplements to prevent miscarriage and instructed to follow up with her obstetrician for routine prenatal care. She was reassured that the ultrasound findings were normal and that she had a high chance of having a healthy pregnancy and delivery.
# Conclusion
Ultrasound is an essential modality for evaluating early pregnancy and detecting potential complications. In this case, ultrasound confirmed a normal intrauterine pregnancy of 5 weeks and excluded ectopic pregnancy, which is a major cause of maternal mortality. Ultrasound also revealed a right corpus luteum cyst, which is a common and benign finding in the first trimester. The patient was managed conservatively and had a good prognosis. This case illustrates the importance of ultrasound in early pregnancy.
References:
(1) 5-Week Ultrasound: What to Expect, What You'll See, and More - Healthline. https://www.healthline.com/health/pregnancy/5-week-ultrasound.
(2) Different Sonographic Faces of Ectopic Pregnancy. https://clinicalimagingscience.org/different-sonographic-faces-of-ectopic-pregnancy/.
(3) Ultrasound Images of Early Pregnancy. https://www.ultrasound-images.com/early-pregnancy/.
(4) First-Trimester Ultrasound: Early Pregnancy Failure. https://link.springer.com/chapter/10.1007/978-3-031-24133-8_16.
(5) Pregnancy of unknown location | Radiology Reference Article .... https://radiopaedia.org/articles/pregnancy-of-unknown-location?lang=us.
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