Hepatic pregnancy managed conservatively

Ramphal, S.; Moodley, J.; Rajaruthnam, Direndra

doi:10.1258/td.2009.090218

Cited by 18 publications

(19 citation statements)

References 4 publications

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“…En 29 casos la placenta se dejó in situ (13, 14, 17, 19, 22, 23, 26-28, 33, 34, 38, 43, 45, 46, 48-50, 53, 54). De esos 29, 5 recibieron metrotexate (13,23,43,54), 6 requirieron remoción quirúrgica durante una segunda intervención (13,33,46,48,50) y uno recibió los dos manejos (27). La placenta fue removida quirúrgicamente en 42 casos y de estos, dos requirieron histerectomía (17,20) o salpingooforectomía unilateral (15,21), siendo la hemorragia la principal complicación (13-16, 18, 20-22, 24, 25, 29-33, 36, 37, 39-42, 44, 45, 47, 49, 51, 52).…”

Section: Resultsunclassified

Embarazo ectópico abdominal avanzado: reporte de casos y revisión de la literatura

Escobar-Vidarte

Caicedo-Herrera

Solarte-Erazo

et al. 2017

Rev. Colomb. Obstet. Ginecol.

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RepoRte de caso Rev Colomb Obstet Ginecol 2017;68:71-82 RESUMENObjetivo: reportar dos casos de embarazo ectópico abdominal avanzado, con buen resultado materno / perinatal, y revisar la literatura disponible con respecto al manejo de la placenta y el pronóstico de esta entidad. Materiales y métodos: se describen dos casos de embarazo ectópico abdominal avanzado en los que se realizó extracción de la placenta, con feto viable y resultado perinatal favorable. Estos fueron atendidos en una institución de cuarto nivel de complejidad, Recibido: junio 14/16 -Aceptado: marzo 3/17 ubicada en la ciudad de Cali, Colombia. Se realizó una revisión de la literatura registrada en las bases de datos Medline vía PubMed, con los términos de búsqueda: "embarazo abdominal", "embarazo esplénico", "embarazo hepático", "embarazo omental" y "embarazo peritoneal". La búsqueda se limitó a artículos publicados durante los últimos doce años en inglés y español. Resultados: se recuperaron 228 referencias, de las cuales 42 artículos cumplieron con los criterios de inclusión que informan un total de 74 pacientes con embarazo ectópico abdominal. En cuanto al manejo de la placenta, la remoción de la misma se informó en 42 casos (58%). La mortalidad materna se presentó en 4 casos (4,1%), todos por hemorragia posparto. Un total de 60 pacientes (81%) presentaron complicaciones, la más frecuente fue hemorragia en 38 de ellas (51%). En cuanto al resultado perinatal, se encontró una mortalidad perinatal del 43%. Conclusión: el manejo de la placenta es el punto clave del que podría depender la frecuencia de complicaciones maternas. Se requieren estudios prospectivos que evalúen el manejo más seguro y efectivo de esta condición. Palabras clave: embarazo abdominal, embarazo ectópico, hemorragia, resultado del embarazo. ABSTRACTObjective: Report two cases of advanced ectopic abdominal pregnancy with good maternal/perinatal outcomes, and to review the literature available regarding the management of the placenta and the prognosis for this condition. Materials and methods: Description of two cases of advanced ectopic abdominal pregnancies with viable fetuses and favourable perinatal outcomes, in which the placenta was removed. The cases were seen at a Level IV institution in the city of Cali, Colombia. Review of the literature registered in the Medline data base via Pubmed using the search terms "abdominal pregnancy", "splenic pregnancy", "hepatic pregnancy", "omental pregnancy" and "peritoneal pregnancy". The search was limited to articles published in English and Spanish during the past 12 years. Results: Overall, 228 references were retrieved, of which 42 articles reporting on a total of 74 patients with ectopic abdominal pregnancy met the inclusion criteria. Regarding the management of the placenta, it was removed in 42 cases (58%). There were 4 cases of maternal mortality (4,1%) all of them due to postpartum bleeding. Complications occurred in 60 patients (81%), bleeding being the most frequent in 38 of them (51%). As for perinatal outcome, peri...

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Section: Resultsunclassified

Embarazo ectópico abdominal avanzado: reporte de casos y revisión de la literatura

Escobar-Vidarte

Caicedo-Herrera

Solarte-Erazo

et al. 2017

Rev. Colomb. Obstet. Ginecol.

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“…Location in the liver is extremely rare. Using “hepatic pregnancy”, “hepatic ectopic pregnancy”, and “primary hepatic pregnancy” as keywords in PubMed, only 21 cases have been reported in the English literature of which four were in Africa [3–6], and of the 21 reported cases, one had medical treatment only [7]. …”

Section: Discussionmentioning

confidence: 99%

Successful medical treatment of a hepatic pregnancy: a case report

et al. 2017

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BackgroundHepatic pregnancy is a rare form of abdominal pregnancy, often documented only as case reports.Case presentationWe report here the case of a 24-year-old African woman, gravida 4 para 3, presenting with right upper quadrant pains and metrorrhagia after amenorrhea of 8 weeks 5 days. Elements in favor of the diagnosis of hepatic pregnancy were her clinical presentation, the kinetics of β-human chorionic gonadotropin titers, and the presence of a sub-hepatic mass on ultrasound. We successfully treated this patient with intramuscular methotrexate only.ConclusionsThe interest of this case resides in the rarity of this condition and the therapeutic approach used. Clinicians should raise their index of suspicion for hepatic pregnancy when faced with females of reproductive age with such a clinical presentation.

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“…[3] The insertion of arterial catheters just prior to surgery for embolization is also given as an option. Ramphal et al[4] reported hepatic pregnancy which was managed conservatively. They diagnosed it at 18 weeks and continued the pregnancy till 34 weeks.…”

Section: Discussionmentioning

confidence: 99%

Primary hepatic pregnancy

Yadav

Chitra

Agarwal

et al. 2012

J Emerg Trauma Shock

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A 25-year-old G2P1L1 woman with 18-week pregnancy presented with right hypochondriac pain and vomiting for the past 1 week. She had borderline vitals and a diffusely tender abdomen. Ultrasound revealed a live 18-week fetus attached to the undersurface of the liver with moderate ascites. Laparotomy was carried out which revealed 500 cc of hemoperitoneum with a primary hepatic pregnancy of the right lobe of liver and bleeding from the placental site. After extracting the fetus, the placenta was left inn situ and the abdomen was packed to control the bleeding as other hemostatic measures failed. Hepatic artery embolization was done after surgery followed by relaparotomy but the abdomen had to be repacked again as the patient was unstable with uncontrollable bleeding. The patient succumbed to DIC despite adequate replacement. In retrospect, the authors conclude that embolization could have been done before surgery and partial hepatic resection attempted in the first instance.

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Hepatic pregnancy managed conservatively

Cited by 18 publications

References 4 publications

Embarazo ectópico abdominal avanzado: reporte de casos y revisión de la literatura

Embarazo ectópico abdominal avanzado: reporte de casos y revisión de la literatura

Successful medical treatment of a hepatic pregnancy: a case report

Primary hepatic pregnancy

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