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Successful operative management of an intact second trimester abdominal pregnancy with additional preoperative selective catheter embolization and postoperative methotrexate therapy.

Demendi C, Langmár Z, Bánhidy F, Börzsönyi B, Csatlós É, Joó JG - Med. Sci. Monit. (2011)

Bottom Line: The pregnancy was terminated safely by laparotomy a day later.The placenta was left in the abdominal cavity because of the high risk of massive and often uncontrollable bleeding, and treatment with methotrexate was applied postoperatively.Preoperative embolization and the postoperative methotrexate therapy facilitate the safe surgical treatment of abdominal pregnancy.

View Article: PubMed Central - PubMed

Affiliation: 2nd Department of Obstetrics and Gynecology, Semmelweis University, Budapest, Hungary.

ABSTRACT

Background: Abdominal pregnancy is a rare condition that may lead to severe complications.

Case report: The authors report the case of a 17-week intact abdominal pregnancy diagnosed in the course of an investigation of lower abdominal pain. Ultrasonography and MR examination revealed an intact abdominal pregnancy. Subsequent angiography was performed to occlude the supportive artery of the pregnancy by selective embolization. The pregnancy was terminated safely by laparotomy a day later. The placenta was left in the abdominal cavity because of the high risk of massive and often uncontrollable bleeding, and treatment with methotrexate was applied postoperatively.

Conclusions: Preoperative embolization and the postoperative methotrexate therapy facilitate the safe surgical treatment of abdominal pregnancy.

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The same view after the embolization.
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f2-medscimonit-17-5-cs53: The same view after the embolization.

Mentions: The patient was referred to the Department of Cardiovascular Surgery, Semmelweis University, for a selective angiography and embolization. Selective angiography verified a normal upper and lower as well as internal iliac artery. In the height of the right renal artery a winding artery was noticed running towards the pelvis minor, which was suspected to be the ovarian artery. This artery was hypertrophic, thicker than usual, with a winding shape, and seemed to supply a parenchymal bulge situated to the right of the uterus. Other branches were leading to the uterus. A selective embolization of this artery was performed with PVA (polyvinyl alcohol) particles. During the control angiography, minimal parenchymal perfusion was seen (Figures 1, 2).


Successful operative management of an intact second trimester abdominal pregnancy with additional preoperative selective catheter embolization and postoperative methotrexate therapy.

Demendi C, Langmár Z, Bánhidy F, Börzsönyi B, Csatlós É, Joó JG - Med. Sci. Monit. (2011)

The same view after the embolization.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3539596&req=5

f2-medscimonit-17-5-cs53: The same view after the embolization.
Mentions: The patient was referred to the Department of Cardiovascular Surgery, Semmelweis University, for a selective angiography and embolization. Selective angiography verified a normal upper and lower as well as internal iliac artery. In the height of the right renal artery a winding artery was noticed running towards the pelvis minor, which was suspected to be the ovarian artery. This artery was hypertrophic, thicker than usual, with a winding shape, and seemed to supply a parenchymal bulge situated to the right of the uterus. Other branches were leading to the uterus. A selective embolization of this artery was performed with PVA (polyvinyl alcohol) particles. During the control angiography, minimal parenchymal perfusion was seen (Figures 1, 2).

Bottom Line: The pregnancy was terminated safely by laparotomy a day later.The placenta was left in the abdominal cavity because of the high risk of massive and often uncontrollable bleeding, and treatment with methotrexate was applied postoperatively.Preoperative embolization and the postoperative methotrexate therapy facilitate the safe surgical treatment of abdominal pregnancy.

View Article: PubMed Central - PubMed

Affiliation: 2nd Department of Obstetrics and Gynecology, Semmelweis University, Budapest, Hungary.

ABSTRACT

Background: Abdominal pregnancy is a rare condition that may lead to severe complications.

Case report: The authors report the case of a 17-week intact abdominal pregnancy diagnosed in the course of an investigation of lower abdominal pain. Ultrasonography and MR examination revealed an intact abdominal pregnancy. Subsequent angiography was performed to occlude the supportive artery of the pregnancy by selective embolization. The pregnancy was terminated safely by laparotomy a day later. The placenta was left in the abdominal cavity because of the high risk of massive and often uncontrollable bleeding, and treatment with methotrexate was applied postoperatively.

Conclusions: Preoperative embolization and the postoperative methotrexate therapy facilitate the safe surgical treatment of abdominal pregnancy.

Show MeSH
Related in: MedlinePlus