Minimally Invasive Management of 14.5‐Week Abdominal Pregnancy Without Laparotomy

Mitra, Avick G.; LeQuire, Mark H.

doi:10.7863/jum.2003.22.7.709

Cited by 17 publications

(4 citation statements)

References 13 publications

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“…There were 10 cases of an abdominal pregnancy being implanted retroperitoneally [151,152,153,154,155,156,157,158,159,160]. The average age at diagnosis was 8 weeks 5 days with a range of 5–18 weeks with an average maternal age of 29.4 years and parity of 1.1.…”

Section: Resultsmentioning

confidence: 99%

“…The average age at diagnosis was 8 weeks 5 days with a range of 5–18 weeks with an average maternal age of 29.4 years and parity of 1.1. Eight of the cases were initially treated surgically with complete removal of the products of conception except for 1 successful case of intracardiac methotrexate (50 mg) and KCl (2 mEq) with IM methotrexate (50 mg/m 2 ) in a pregnancy implanted over the bifurcation of the left common iliac artery [158] and 1 case of failed medical management with two doses of methotrexate [156]. …”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Early Abdominal Ectopic Pregnancies: A Systematic Review of the Literature

Poole¹,

Haas

Magann

2012

Gynecol Obstet Invest

134

145

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Objective: To define abdominal ectopic pregnancy outcomes by both location and treatment. Methods: Literature review of abdominal pregnancies from 1965 to August of 2009. Ectopic pregnancy exclusions were interstitial, tubal, cervical, ovarian, or those beyond 20 weeks at diagnosis/treatment. Results: There were 511 cases identified with 225 meeting the inclusion criteria. There were 7 maternal deaths (3.0%) with 18 (8%) of the early abdominal ectopic pregnancies occurring with an intrauterine device in place. Mean gestational age at the time of treatment was 10 weeks 0 days and mean maternal age was 29.7 years. The average blood loss associated with treatment was 1,450 ml. The top three sites of early abdominal ectopic pregnancies were pouches around the uterus (24.3%), serosal surface of the uterus and tubes (23.9%), and multiple sites (12.8%). Primary surgical management was performed in 208 cases (87.8%). Nonsurgical adjuvant or primary therapy included intramuscular methotrexate, intralesional methotrexate, intracardiac KCl, and artery embolization. Conclusion: Abdominal pregnancies should be considered in all patients until an intrauterine location can be confirmed. Understanding treatment options by pregnancy location may be helpful in the management of this potentially life-threatening condition.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Early Abdominal Ectopic Pregnancies: A Systematic Review of the Literature

Poole¹,

Haas

Magann

2012

Gynecol Obstet Invest

134

145

View full text Add to dashboard Cite

show abstract

“…Retention of the placenta in situ is not without its attendant risks and postoperative morbidity can be substantial. Secondary hemorrhage, abscess formation, paralytic ileus, bowel obstruction, pre-eclampsia and eclampsia have all been reported as complications of leaving the placenta in situ [11]. Any modality which can offer a reduction of intra-operative vascularity and hence blood loss would be a boon for these patients.…”

Section: Discussionmentioning

confidence: 99%

“…In another study, the patient was managed at 19 weeks of pregnancy by sonographically guided intracardiac potassium chloride with an intramuscular injection of 50 mg/m 2 methotrexate. This patient had no surgical intervention and complete resorption occurred over a period of 1.5 years [11]. …”

Section: Discussionmentioning

confidence: 99%

Secondary abdominal pregnancy and its associated diagnostic and operative dilemma: three case reports

et al. 2009

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IntroductionAbdominal pregnancy is extremely rare and has historically been defined as an implantation in the peritoneal cavity, exclusive of tubal, ovarian or intraligamentary pregnancy.Case presentationsThree cases are reported. All came from a lower middle-income group and all of them were subjected to surgery. The first patient was a 30-year-old woman, who was pregnant for the fourth time, who presented at 16 weeks with an abdominal pregnancy. She was admitted with constant abdominal pain and retention of urine. She was hemodynamically stable and was administered a pre-operative intramuscular injection of methotrexate. During laparotomy she had only minor blood loss, the major part of the placenta was removed easily and she did not require any blood transfusion. Serum beta human chorionic gonadotrophin values and ultrasound follow-up revealed a normal study four weeks after surgery. The second patient was a 26-year-old woman, pregnant for the third time, admitted at 14 weeks with an abdominal pregnancy with hemoperitoneum, and the third patient was a 24-year-old woman, pregnant for the first time, who presented at 36 weeks gestation. She was only diagnosed as having an abdominal pregnancy during surgery, experienced excessive blood loss and required a longer hospital stay.ConclusionsWe hypothesize that treatment with pre-operative systemic methotrexate with subsequent laparotomy for removal of the fetus and placenta may minimize potential blood loss, and would be a reasonable approach in the care of a patient with an abdominal pregnancy with placental implantation to the abdominal viscera and blood vessels. This treatment option should be considered in the management of this potentially life-threatening condition. During surgery, if the placenta is attached to vital organs it should be left behind. Early diagnosis can help in reducing associated maternal morbidity and mortality.

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Interventions for non-tubal ectopic pregnancy

Shen

Huang

et al. 2014

Cochrane Database of Systematic Reviews

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Minimally Invasive Management of 14.5‐Week Abdominal Pregnancy Without Laparotomy

Cited by 17 publications

References 13 publications

Early Abdominal Ectopic Pregnancies: A Systematic Review of the Literature

Early Abdominal Ectopic Pregnancies: A Systematic Review of the Literature

Secondary abdominal pregnancy and its associated diagnostic and operative dilemma: three case reports

Interventions for non-tubal ectopic pregnancy

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