Minimally invasive management of an advanced abdominal pregnancy.

Abstract

BACKGROUND:

Advanced abdominal pregnancy is a rare, life-threatening condition that presents a number of challenges.

CASE:

A 29-year-old primigravida with 10 years of secondary infertility and a previous tuboplasty had a 21-week abdominal pregnancy treated with preoperative arterial embolization before laparoscopically assisted fetal delivery. Postoperatively, 4 cycles of methotrexate were administered at 50 mg/m2 intramuscularly every 3 weeks for the retained abdominal placenta. Subsequent spontaneous conception occurred, and a live, full-term infant was delivered by cesarean delivery 17 months later. No adverse sequelae were found during long-term follow-up.

CONCLUSION:

This report demonstrates successful minimally invasive management of an advanced abdominal pregnancy with a multimodal approach that included preoperative arterial embolization, laparoscopically assisted delivery, and judicious use of postoperative methotrexate.

• Authors: Jamal Rahaman, Richard Berkowitz, Harold Mitty, Sreedhar Gaddipati, Barry Brown, Farr Nezhat
• Journal: Obstetrics and gynecology (Obstet Gynecol) Vol. 103 Issue 5 Pt 2 Pg. 1064-8 (May 2004) ISSN: 0029-7844 [Print] United States
• PMID: 15121609 (Publication Type: Case Reports, Journal Article)

Chemical References

• Methotrexate

Topics

• Adult
• Cesarean Section
• Combined Modality Therapy
• Delivery, Obstetric (methods)
• Embolization, Therapeutic
• Female
• Humans
• Injections, Intramuscular
• Laparoscopy
• Magnetic Resonance Imaging
• Methotrexate (administration & dosage)
• Placenta, Retained (therapy)
• Postoperative Care
• Pregnancy
• Pregnancy, Abdominal (diagnosis, therapy)