Primary Abdominal Pregnancy in the Uterosacral Ligament with Haemoperitoneum: A Near Miss

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

“…However, peritoneal pregnancy could cause sudden and serious bleeding even at earlier stages of pregnancy when a tubal pregnancy does not cause massive bleeding. Therefore, we reviewed the literature to evaluate the common symptoms of peritoneal pregnancy at 5 weeks of gestation . Consistent with previous reports, we observed no genital bleeding or gestational sac within the uterus in spite of massive intraperitoneal bleeding and abdominal pain (Table ).…”

“…Both of our patients exhibited massive hemoperitoneum at 5 weeks of gestation; in particular, the patient in Case 1 exhibited more than 2000 mL of bleeding. Omental pregnancy and peritoneal pregnancy implanted on the uterosacral ligamentum are also known to cause massive bleeding at 5 gestational weeks, even at day 24 of menstruation (Table 1, Cases 3, 4 and 5) [10,11,28]. Thus, massive bleeding in early gestation, such as at 5 weeks in the present cases, may imply the presence of a peritoneal pregnancy.…”

“…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].…”

“…Until 7 weeks of gestation, massive hemoperitoneum is rare in tubal pregnancies, which is the most common implantation site among ectopic pregnancies . There are no reported cases of massive hemoperitoneum associated with peritoneal pregnancy at 5 weeks of gestation except in the omentum and the uterosacral ligament . We recently encountered two unique cases of primary peritoneal pregnancy with severe bleeding at a very early gestational age.…”

Determination of Human Chorionic Gonadotropin in Postmortem Samples in Ectopic Pregnancies

“…Other sites include the fimbria of the fallopian tube, interstitial or, cornual region of the myometrium, cervix, ovary, pelvic cul‐de‐ac, broad ligament, bowel, pelvic sidewall, and Caesarian section scars. The most assumed and identified risk factors include advancing maternal age, previous ectopic pregnancy, tubal infection or surgery, pelvic inflammatory disease, previous spontaneous miscarriage, uterine anomalies, use of an intrauterine contraceptive device, and assisted reproductive techniques (e.g., in vitro fertilization and fertility treatments involving superovulatory drugs) .…”