Advancing surgical techniques during abdominal sacrocolpopexy: the case for interdisciplinary discussions over coffee

Abstract

Abdominal pregnancy is a rare variant of ectopic pregnancy which occurs when the gestational sac is implanted outside the uterus, ovaries and fallopian tubes. It constitutes approximately 1% of ectopic pregnancies, 1 and has a reported incidence of one in 2200 to one in 10,200 of all pregnancies, and one in 6000 births. 2 While abdominal pregnancies may reach term the fetal mortality rate varies from 30% to 95% 3,4 and the maternal mortality rate can be as high as 20%. 2 The fetal abnormality rates range from 30% to 100%, most of which are secondary to oligohydramnios and a constricted extrauterine environment, such as lung hypoplasia and pressure related deformities. 2 Hence, with the high risk to the mother and the improbability of a normal, viable fetus, immediate termination and removal of the pregnancy is advisable. Although successful non-surgical management of abdominal pregnancy has been reported, 5 surgical management is usually required. While this is traditionally done via a laparotomy, there have been five cases of laparoscopic management of abdominal pregnancy reported in the English literature.We report the identification and laparoscopic management of an early primary abdominal pregnancy. To the best of our knowledge, this is the first report in Australia of an abdominal pregnancy managed laparoscopically.