The tourist arrived at Hanoi French Hospital with severe abdominal pain. Clinical examination, laboratory tests and ultrasound revealed an approximately 7 cm mass in her right adnexa, along with signs of fluid pooling in her abdominal cavity.
The findings pointed to two possible emergencies, a ruptured ectopic pregnancy or a ruptured ovarian cyst with torsion. Either could cause rapid internal bleeding, and an mergency laparoscopic surgery was ordered.
“In this patient, there was also an ovarian mass sitting right next to the ectopic pregnancy. That made detection difficult and easy to miss,” Ngo Thi Bang, a senior physician in the hospital’s Obstetrics and Gynecology Department, spoke about the case on April 20.
A French patient (L) is discharged in stable condition two days after surgery for a ruptured ectopic pregnancy at Hanoi French Hospital. Photo courtesy of Hanoi French Hospital |
Her earlier examinations in France had followed a pattern that can mask an ectopic pregnancy in its most dangerous form. Some ectopic pregnancies produce what is called a pseudogestational sac, a fluid collection inside the uterus that can look like a normal pregnancy on ultrasound. When the sac breaks down, the patient experiences abdominal pain, bleeding and tissue discharge that closely resemble a miscarriage. Meanwhile, the ectopic pregnancy continues to grow undetected, usually inside a fallopian tube, until it ruptures.
At two hospital visits in France she was told she had miscarried. But her pain worsened rather than faded, and she continued to bleed for weeks. By the time she reached Hanoi French Hospital, the ectopic pregnancy had burst into her abdomen.
During surgery, the team confirmed both the ruptured ectopic pregnancy and a hemorrhagic ovarian cyst. They removed the ectopic tissue and dissected out the cyst while preserving the ovary to protect the patient’s hormonal function and future fertility. The laparoscopic approach limited blood loss and allowed faster recovery than open surgery. She was discharged in stable condition two days later.
Ruptured ectopic pregnancies are a life-threatening emergency. The fertilized egg implants outside the uterus, most often in a fallopian tube, and when the tissue tears, it bleeds into the abdominal cavity. Without rapid intervention, the blood loss can be fatal within hours.
Bang said the case illustrates why pregnant women should seek early examination to confirm the pregnancy has implanted inside the uterus, particularly when symptoms are ambiguous. In difficult cases, she said, repeat monitoring is essential to avoid a missed diagnosis. Early detection and timely intervention are critical not only to preserving the patient’s health but also to protecting long-term fertility.
She also urged women of reproductive age to undergo regular gynecological check-ups even in the absence of symptoms, to catch conditions such as ovarian cysts, uterine fibroids or cervical lesions before they develop into dangerous complications.
Hanoi French Hospital, founded in 1997 as the city’s first international hospital, has long been a destination for expatriate and foreign patients in northern Vietnam.
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