Case patient xxx, female, 35 years old Symptom: amenorrhea for 47 days i spot vaginal bleeding for 3 days; sudden abdominal pain for 2 hours Signs: Bp 12/ 8Kpa, P 120 times/min, abdominal tenderness and rebound tenderness(+); sharp pain on motion of the cervix sonography: a 4X5 cm irregular mass, 3 cm-depth fluid in cul-de-sac culdocentesis: 2 ml bloody fluid did not clot) urine HCG(+Case patient xxx, female, 35 years old Symptom: amenorrhea for 47 days ; spot vaginal bleeding for 3 days; sudden abdominal pain for 2 hours. Signs: Bp 12/8Kpa, P 120 times/min, abdominal tenderness and rebound tenderness (+); sharp pain on motion of the cervix. sonography: a 4X5 cm irregular mass, 3 cm-depth fluid in cul-de- sac culdocentesis: 2 ml bloody fluid (did not clot) urine HCG (+)