Successful medical treatment of a hepatic pregnancy: a case report

Abstract

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.

Abortive Retroperitoneal Ectopic Pregnancy Followed Up by Ultrasound: A Case Report

“…Injuries to the attached organs of the pregnancy are also more common. Some researches reported methotrexate injection can effectively reduce bleeding and protect future fertility [2,5,14]. This case was found earlier.…”

Primary hepatic pregnancy: report of a case treated with laparoscopic approach and review of the literature

“…This approach was reported in a case of hepatic pregnancy diagnosed by abdominal US. The case met the Fernandez score (46) in a hemodynamically stable patient (39).…”

Application of ultrasound in hepatic pregnancy: a case report and literature review

“…Before December 1988, ten cases of hepatic pregnancy [5,[9][10][11][12][13][14][15][16][17] had been reported, two of which were diagnosed preoperatively by X-ray [16,17], accounting for 20%, and eight of which were diagnosed during intraoperative exploration or after postoperative pathology, accounting for 80%. From January 1989 to December 2018, 23 cases of hepatic pregnancy have been reported, including 18 cases [5,8,9,11,[18][19][20][21][22][23][24][25][26][27][28][29][30][31] diagnosed preoperatively by ultrasonography (78.3%), two cases by other imaging modalities (including one by CT [2] and one by CT combined with MRI [32]), accounting for 8.7%, and three cases diagnosed by emergency laparotomy [33,34] or laparoscopy [3], accounting for 13.0%. A description of the 18 cases diagnosed by abdominal ultrasound is presented in Table 1.…”