A broad ligament pregnancy successfully managed by laparoscopy

Combined surgical and medical management of a broad ligament ectopic pregnancy: A case report

Broad ligament ectopic pregnancies rare. Several case reports illustrate treatment with laparoscopy. A 31-year-old woman, gravida 2 para 1, presented at 6 weeks 6 days of gestation with vaginal bleeding. She had a β-hCG level of 7424 IU/L and ultrasound showed a 1.8 cm ectopic pregnancy with fetal cardiac activity in the left adnexa. Diagnostic laparoscopy revealed a left broad ligament ectopic pregnancy. The products of conception were removed surgically, and she received prophylactic two-dose methotrexate. Her β-hCG returned to non-pregnant levels within one month. This is the first case report to describe laparoscopy with postoperative prophylactic methotrexate for successful treatment of a broad ligament pregnancy. This treatment protocol with methotrexate can be considered in future cases.

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Broad ligament ectopic pregnancies are rare and often diagnosed intraoperatively.

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Several case reports document successful treatment of these pregnancies with surgery.

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Prophylactic methotrexate can be considered if there is concern for retained trophoblastic tissue.

Broad ligament pregnancy: A case series and literature review

Broad ligament pregnancies are rare and are often misdiagnosed, leading to serious consequences. In our hospital, we have treated six broad ligament pregnancies since 2000. They were diagnosed and operated on promptly, and treatment was successful. Ultrasound can detect early ectopic pregnancies promptly and effectively, avoiding advanced ectopic pregnancies. Early broad ligament pregnancies should be operated on promptly, and laparoscopic therapy is preferable. During the operation, attention must be paid to avoid massive bleeding and protect the ureter, because the ectopic gestational sac is located near the uterine artery and the ureter.

Rare Ectopic Pregnancies - A Literature Review for the Period 2007 - 2019 on Locations Outside the Uterus and Fallopian Tubes

The majority of ectopic pregnancies (EP) are tubal pregnancies, but other implantation sites outside the uterus and tubes are also found. These rare EP locations present a particular diagnostic and therapeutic challenge. We present an overview of potential very rare locations of ectopic pregnancies, their symptoms, diagnosis and treatment, based on a systematic analysis of case reports. A literature review of the databases PubMed, Livivo and Google Scholar for the period 2007 to 2019 was carried out. A total of 113 publications were included in our review. These studies describe EP implantations in the posterior cul-de-sac, on the uterine serosa and uterine ligaments, in the vicinity of almost all intraperitoneal organs, on the abdominal wall as well as in retroperitoneal sites. The most common presenting symptom was abdominal pain occurring in different locations. The diagnostic procedures included various imaging procedures and/or explorative surgery at different advanced stages of pregnancy. The most common and preferred option was laparotomy for surgical treatment. The placenta was successfully resected in the majority of cases. A rare EP location should be considered when making a differential diagnosis in patients of child-bearing age with abdominal pain.