Broad ligament ectopic pregnancy: a dilemma to diagnose

Authors

  • Namrata Saxena Department of Obstetrics and Gynecology, SGRRIM and HS, Dehradun, Uttarakhand, India
  • Neeta Bansal Department of Obstetrics and Gynecology, SGRRIM and HS, Dehradun, Uttarakhand, India
  • Pradeep Singhal Department of Surgery, SGRRIM and HS, Dehradun, Uttarakhand, India
  • Monika Ramola Department of Obstetrics and Gynecology, SGRRIM and HS, Dehradun, Uttarakhand, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20190317

Keywords:

Broad ligament, Ectopic pregnancy, Laparoscopy

Abstract

Broad ligament ectopic pregnancy is a rare and serious form of extrauterine pregnancy with a high risk of maternal mortality. There are no specific clinical features. Ultrasonography may help in diagnosis, but definitive diagnosis is made only during surgery. Authors are reporting a case of 30 years female G3P1L1A1 seven weeks pregnancy with previous lower segment cesarean section and previous history of right sided salpingectomy with no complaints. Ultrasound was advised to know the location of sac this time, in which, she was diagnosed as a case right sided unruptured live ovarian ectopic pregnancy. On examination, signs and symptoms of ectopic pregnancy were absent. On laparoscopy, she was diagnosed as a case of right sided live unruptured broad ligament ectopic pregnancy as her right ovary was absent because of previous surgery.  With advances in sonography and laparoscopic skills, more cases can be diagnosed in the first trimester and can be safely managed laparoscopically.

 

References

Bobyer J, Coste J, Fernandez H, Pouly JL, JobSpira N. Sites of ectopic pregnancy: a 10 year population based study of 1800 cases. Hum Reprod. 2008;17:3224-30.

Cordero DR, Adra A, Yasin S, O’Sullivan MJ. Intraligamentary pregnancy. Obstet Gynecol Surv. 1994;49(3):206-9.

Phupong V, Lertkhachonsuk R, Triratanachat S, Sueblinvong T. Pregnancy in the broad ligament. Arch Gynecol Obstet. 2003;268(3):233-5.

Chia KV, Fayle RJS, Ferriman E. Intraligamentary pregnancy. J Obstet Gynaecol. 1993;13:254.

Alto WA. Abdominal pregnancy. Am Fam Physician. 1990;41:209-14.

Paterson WG, Grant KA. Advanced intraligamentous pregnancy. Report of a case, review of the literature and a discussion of the biological implications. Obstet Gynecol Surv. 1975;30:715-26.

Vierhout ME, Wallenburg HC. Intraligamentary pregnancy resulting in a live infant. Am J Obstet Gynecol. 1985;152:878-9.

Hallatt JG, Grove JA. Abdominal pregnancy: a study of twenty-one consecutive cases. Am J Obstet Gynecol. 1985;152:444-9.

Malian V, Lee JE. MR imaging and MR angiography of an abdominal pregnancy with placental infarction. Am J Roentgenol. 2001;177(6):1305-6.

Yoshigi J, yashiro N, kinoshita T, o'uchi T, kitagaki H. Diagnosis of ectopic pregnancy with MRI: efficacy of T2*-weighted imaging. Magnet Reson Med Sci. 2006;5(1):25-32.

Pisarska MD, Casson PR, Moise Jr KJ, DiMaio DJ, Buster JE, Carson SA. Heterotopic abdominal pregnancy treated at laparoscopy. Fertil Steril. 1998;70(1):159-60.

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Published

2019-01-25

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Section

Case Reports