Laparoscopic management of early primary peritoneal pregnancy: a case report

Abstract

Peritoneal pregnancy is an implantation in the peritoneal cavity exclusive of tubal, ovarian, or intra-ligamentary implantations. This is a rare obstetric complication with high maternal mortality and even higher perinatal mortality, and secondary type was most common. Risk factors for peritoneal pregnancy are previous history of extrauterine pregnancy or tubal surgery pelvic post-inflammatory status or presence of an intra-uterine device. As it is a life-threatening condition, expectant management carries a risk of sudden life-threatening intra-abdominal bleeding and a generally poor fetal prognosis. So, when it is recognized, immediate termination of pregnancy is usually recommended. Early diagnosis of peritoneal pregnancy is difficult, but is important by their life threatening progress course to patients. Recently, we experienced primary peritoneal pregnancy which meets both the original and modified criteria. In this paper, we reported the case of early diagnosed and successfully treated peritoneal pregnancy despite of their diagnosis was incidentally.

Peritoneal pregnancy with massive hemoperitoneum in early gestation: two case reports

“…Early diagnosis of peritoneal pregnancy is difficult but important because of the life-threatening nature of this complication. Several recent reports have demonstrated the effectiveness of laparoscopy in the diagnosis and treatment of peritoneal pregnancy [5,[7][8][9][10][11][12][13][14][15].…”

Laparoscopic management of primary abdominal pregnancy located on the sigmoid colon: A case report

“…In their study, Bang Ntamack, et al report an incidence of 1/4447 births [1]. Infertility and IUD contraception are also found among the risk factors of the AP [1][2][3][4][5].…”

“…Maternal mortality associated with AP is 7.7 times greater than those associated with other ectopic pregnancies and 90 times higher than those associated with intrauterine pregnancies [5,11,12]. Poole et al [11], postulate that the high risk of mortality in AP is due to delay in diagnosis.…”

“…In fact, at least 5 cases of AP that were misdiagnosed at the first laparoscopy were reported in the world literature [4,5,10,14,15]. However, two cases were formidable pitfalls [14,15].…”

Analyzing the clinical significance of postoperative methotrexate in the management of early abdominal pregnancy: analysis of 10 cases

“…Diagnostic laparoscopy has become the cornerstone treatment for AEP, but they can also be managed medically with systemic or local methotrexate (MTX), ultrasound guided potassium chloride (KCL), danazol and mifepristone [6,7]. While few cases of early abdominal cases have been managed with surgery plus methotrexate, no studies, according to our knowledge have investigated the importance of methotrexate in these scenarios [8,9]. We retrospectively studied the records of ten (10) who were diagnosed with early abdominal pregnancy in our hospital and were managed with surgery alone or surgery plus MTX.…”