Abdominal ectopic pregnancies are an extremely rare type of ectopic pregnancy.
They are thought to represent around 1.4% of all ectopic pregnancies 6 with an estimated incidence of 1:1000-10,000 births.
It is often thought that they most frequently result from a tubal rupture with subsequent reimplantation of the conceptus onto bowel, omentum or mesentery (in very rare situations primary abdominal ectopic may also occur). Uncommon cases when it develops as a result of a scar rupture have also been reported 3.
It typically develops around the ligaments of the ovary (although it can implant anywhere within the abdominal cavity). It can then obtain blood supply from the omentum and abdominal organs. At times these pregnancies migrate out of the pelvis and are seen in the upper abdomen. The placental attachment can also be at unusual sites including the anterior abdominal wall 7.
Ultrasound is often at the frontline of imaging. Sonographically the pregnancy is seen separate from the uterus, adnexa, and ovaries.
May have a role in better delineation of anatomy and relationships especially when the pregnancy is advanced.
- intra-abdominal haemorrhage with massive haemoperitoneum
Treatment and prognosis
It is a serious and potentially life-threatening condition. Maternal mortality associated with intra-abdominal pregnancy is estimated at 7.7 times that of other locations of ectopic pregnancy 6.
Treatment is by often by means of placental embolisation followed by a laparotomy or laparoscopy. While an abdominal pregnancy can result in a life-threatening emergency, especially when diagnosed late in gestation, it can also result in a live birth by means of a laparotomy 1.
First trimester of pregnancy
- ultrasound findings in early pregnancy
- confirming intrauterine gestation
- pregnancy of unknown location (PUL)
- pseudogestational sac
- decidual cast
- tubal ectopic
- atypical ectopic pregnancies
- live ectopic pregnancy
- heterotopic pregnancy
- tubal rupture
- failed early pregnancy
- aneuploidy testing
- gestational trophoblastic disease
Ultrasound - obstetric
- ultrasound (introduction)
- obstetric ultrasound
first trimester and early pregnancy
- gestational sac
- yolk sac
- Beta-hCG levels
- ectopic pregnancy
- multiple gestations
- subchorionic hematoma
- failed early pregnancy
- fetal biometry
- fetal morphology assessment
- soft markers
- echogenic fetal bowel
- umbilical artery Doppler assessment
- nuchal translucency
- chorionic villus sampling (CVS) and amniocentesis
- first trimester and early pregnancy
- 1. Levine D. Ectopic pregnancy. Radiology. 2007;245 (2): 385-97. doi:10.1148/radiol.2452061031 - Pubmed citation
- 2. Williams CH. Ultrasound evaluation of a near-term abdominal ectopic pregnancy. J Clin Ultrasound. 1978;6 (4): 264-5. - Pubmed citation
- 3. Teng HC, Kumar G, Ramli NM. A viable secondary intra-abdominal pregnancy resulting from rupture of uterine scar: role of MRI. Br J Radiol. 2007;80 (955): e134-6. doi:10.1259/bjr/67136731 - Pubmed citation
- 4. Harris MB, Angtuaco T, Frazier CN et-al. Diagnosis of a viable abdominal pregnancy by magnetic resonance imaging. Am. J. Obstet. Gynecol. 1988;159 (1): 150-1. - Pubmed citation
- 5. Malian V, Lee JH. MR imaging and MR angiography of an abdominal pregnancy with placental infarction. AJR Am J Roentgenol. 2001;177 (6): 1305-6. AJR Am J Roentgenol (full text) - Pubmed citation
- 6. Lin EP, Bhatt S, Dogra VS. Diagnostic clues to ectopic pregnancy. Radiographics. 2008;28 (6): 1661-71. doi:10.1148/rg.286085506 - Pubmed citation
- 7. Zaki ZM. An unusual presentation of ectopic pregnancy. Ultrasound Obstet Gynecol. 1998;11 (6): 456-8. doi:10.1046/j.1469-0705.1998.11060456.x - Pubmed citation
Synonyms & Alternative Spellings
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