Transabdominal and transvaginal sonographic evaluation of the pelvis. No intrauterine gestational sac identified. The endometrium has a normal trilaminar secretary phase appearance (11 mm thickness). Extensive complex free fluid within the pelvis, and the right paracolic gutter. The right ovary is normal in appearance, with demonstrable blood flow. The left ovary could not be clearly identified, with extensive heterogenous echogenicity material within the left adnexal region, likely haematoma. No ectopic gestational sac confidently identified, although the appearance of the left adnexa is suspicious for a ruptured ectopic pregnancy .