Discovery of an Ectopic Pregnancy after Attempted Self-Managed Abortion

This correspondence reports a case of a 22 year old patient who presented with severe abdominal pain after a self-managed abortion using mifepristone and misoprostol procured online. Initial ultrasound showed an empty uterus, but subsequent laparoscopy revealed a ruptured ectopic pregnancy. The authors highlight the rising incidence of self-managed abortions in U.S. states with restrictive laws post Dobbs and emphasize the need for clinicians to maintain high suspicion for ectopic pregnancy in such cases, particularly without prior confirmation of intrauterine pregnancy. Key diagnostic markers include persistent beta hCG levels and ultrasound findings of free fluid.

This correspondence reports a case of a 22 year old patient who presented with severe abdominal pain after a self-managed abortion using mifepristone and misoprostol procured online. Initial ultrasound showed an empty uterus, but subsequent laparoscopy revealed a ruptured ectopic pregnancy. The authors highlight the rising incidence of self-managed abortions in U.S. states with restrictive laws post Dobbs and emphasize the need for clinicians to maintain high suspicion for ectopic pregnancy in such cases, particularly without prior confirmation of intrauterine pregnancy. Key diagnostic markers include persistent beta hCG levels and ultrasound findings of free fluid.