Taiwanese Journal of Obstetrics and Gynecology
Volume 44, Issue 2 , Pages 172-174, June 2005

Successful Laparoscopic Management of Primary Abdominal Pregnancy in the Cul-De-Sac

  • Richard Shih-Hung Young

      Affiliations

    • Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan
  • ,
  • Ming-Chao Huang

      Affiliations

    • Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan
    • Mackay Junior Medicine, Nursing and Management College, Taipei, Taiwan
    • Corresponding Author InformationCorrespondence to: Dr. Ming-Chao Huang, Department of Obstetrics and Gynecology, Mackay Memorial Hospital, 92, Section 2, Chung-Shan North Road, Taipei, Taiwan
  • ,
  • Chih-Ping Chen

      Affiliations

    • Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan
    • National Yang-Ming University, Taipei, Taiwan

Received 28 July 2004; received in revised form 28 July 2004; accepted 28 July 2004.

Article Outline

Summary 

Objective

We report a rare case of primary abdominal pregnancy in the Douglas cul-de-sac that was successfully treated with laparoscopy.

Case Report

A 31-year-old primigravida woman had undergone intrauterine insemination 5 weeks prior to presentation. Ultrasound examination at presentation revealed an ectopic gestational sac in the cul-de-sac without any evidence of intrauterine pregnancy, and serum β-human chorionic gonadotropin (β-hCG) was 46,601 mIU/mL. Laparoscopy was performed and revealed an ectopic mass implanted in the cul-de-sac. The gestational tissue was removed by grasping forceps and hydrodissection. Bipolar electrocauterization and tamponading with Surgicel(tm) were used for hemostasis at the defect of the peritoneum. Serum β-hCG fell rapidly after surgery. The patient had a term baby delivered successfully 2 years postoperatively.

Conclusion

Early diagnosis of abdominal pregnancy enabled successful laparoscopic management.

Key Words:  abdominal pregnancy , cul-de-sac , laparoscopy , peritoneal pregnancy

No full text is available. To read the body of this article, please view the PDF online.

 

Back to Article Outline

References 

  1. Martin JN , Sessums JK , Martin RW , Pryor JA , Morrison JC . Abdominal pregnancy: current concepts of management . Obstet Gynecol . 1988;71:549–557
  2. Goldman GA , Dick D , Ovadia J . Primary abdominal pregnancy: can artificial abortion, endometriosis and IUD be etiological factors? . Eur J Obstet Gynecol Reprod Biol . 1988;27:139–143
  3. Salzberg MR . Ectopic pregnancy . N Engl J Med . 1994;330:713–714
  4. Galabin AL . Primary abdominal pregnancy . Brit Med J . 1903;1:664
  5. Studdiford WE . Primary peritoneal pregnancy . Am J Obstet Gynecol . 1942;44:487–491
  6. Makinen J . Histologically verified primary peritoneal pregnancy with implantation in the sigmoid mesenterium . Eur J Obstet Gynecol Reprod Biol . 1986;22:171–174
  7. Friedrich EG , Rankin CA . Primary pelvic peritoneal pregnancy . Obstet Gynecol . 1968;31:649–653
  8. Joong SS , Young JM , Seung RK , Kyung TK , Hyung M , Youn YH . Primary peritoneal pregnancy implanted on the uterosacral ligament: a case report . J Korean Med Sci . 2000;15:359–362
  9. Tsudo T , Harada T , Yoshioka H , Terakawa N . Laparoscopic management of early primary abdominal pregnancy . Obstet Gynecol . 1997;90:687–688
  10. Lee CL , Wang CJ , Chao A , Yen CF , Soong YK . Laparoscopic management of an ectopic pregnancy in a previous Caesarean section scar . Hum Reprod . 1999;14:1234–1236
  11. Siow A , Chern B , Soong Y . Successful laparoscopic treatment of an abdominal pregnancy in the broad ligament . Singapore Med J . 2004;45:88
  12. Geisler JP , Cline M , Eskew N . Successful laparoscopic treatment of an abdominal pregnancy in the posterior culde-sac . Clin Exp Obstet Gynecol . 2000;27:83–84
  13. Costa SD , Presley J , Bastert G . Advanced abdominal pregnancy . Obstet Gynecol Surv . 1991;46:515–525

PII: S1028-4559(09)60133-9

doi:10.1016/S1028-4559(09)60133-9

Taiwanese Journal of Obstetrics and Gynecology
Volume 44, Issue 2 , Pages 172-174, June 2005