Presentation and diagnostic challenges in identifying late first trimester ectopic pregnancy by point-of-care ultrasound.

Vaginal bleeding is a common presenting complaint for patients in the emergency department. It can be associated with life threatening disease entities such as ruptured ectopic pregnancy. This case highlights a young primigravid female presenting with a late first trimester ectopic pregnancy which was initially missed on beside ultrasound but later found on internal quality review. Emergency physicians who perform point-of-care ultrasound for pregnancy related complaints should measure the endomyometrial mantle to aid in the diagnosis of ectopic pregnancy.