Undiagnosed asymptomatic second trimester broad ligament ectopic pregnancy: a case report and mini-review

Abstract

Pregnancy in the broad ligament is a retro

Broad Ligament Pregnancy

“…In the published medical literature, different outcomes for women who underwent laparotomy or laparoscopy for a broad ligament pregnancy can also be found. There have been reported cases where the size of the pregnancy made it possible to be removed without any damage to the surrounding organs [10-12, 14, 15, 17, 19-26, 33, 36-38, 41, 60-62, 64-66], where in other cases salpingectomy [18,27,31,32,40,56,58,67], oophorectomy [30], or salpingo-oophorectomy [28,34,35,39] was necessary to be performed due to the damage these organs presented. There have also been reported cases where the need for hysterectomy presented [20,29,40,68], and finally in a report by Wolfe and Neigus in 1953, among three cases reported, the two patients died [20].…”

Non-tubal ectopic pregnancy

“…The rarest form of ectopic pregnancies is at 0.9-1.4% and relates to implantation at sites throughout the abdomen including omentum; organs such as the liver, spleen, and bowel; large vessels; pelvic cul-de-sac; broad ligament; and pelvic side wall [4,28,[54][55][56]. Abdominal ectopic pregnancy can be defined as primary or secondary; when the fimbrial end does not 'pick up' the ovulated follicle is primary type, tubal abortion via the fimbria and peritoneal implantation related with secondary abdominal ectopics [4,28].…”

“…Delivery is recommended at 34 weeks if fetus has no congenital malformations, and placenta which implanted away from upper abdomen is often left in place to avoid the risk for hemorrhage [65,66]. A few case reports have described subsequent methotrexate treatment and ultrasoundguided injection of potassium chloride [4] or radiological artery embolization to minimize blood loss before leaving placental tissue behind [28,56,[67][68][69].…”

“…The rarity of this type of ectopic pregnancy makes it impossible to have prospective trials so as to conclude the best possible treatment. The reported cases that already can be found in the international medical literature can propose different management options [56], taking into consideration the different means every managing clinician can use.…”

“…In the published medical literature, different outcomes for women who underwent laparotomy or laparoscopy for a broad ligament pregnancy can also be found. There have been reported cases where the size of the pregnancy made it possible to be removed without any damage to the surrounding organs [10-12, 14, 15, 17, 19-26, 33, 36-38, 41, 60-62, 64-66], where in other cases salpingectomy [18,27,31,32,40,56,58,67], oophorectomy [30], or salpingo-oophorectomy [28,34,35,39] was necessary to be performed due to the damage these organs presented. There have also been reported cases where the need for hysterectomy presented [20,29,40,68], and finally in a report by Wolfe and Neigus in 1953, among three cases reported, the two patients died [20].…”