Minimally invasive management of an advanced abdominal pregnancy.

Research paper by Jamal J Rahaman, Richard R Berkowitz, Harold H Mitty, Sreedhar S Gaddipati, Barry B Brown, Farr F Nezhat

Indexed on: 04 May '04Published on: 04 May '04Published in: Obstetrics and gynecology


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