Table 2 Abdominal ectopic case reports
Author (year) | Age/Parity | Infertility etiology | Other pertinent history | Priorectopic | Stimulation Protocol | Egg # | ET no./timing | Fresh/Frozen ET | Max HCG level (mIU/ml) | Location (E/H) | Stage at diagnosis | Rupture? | Intervention | Outcome |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Oehniger (1988) [23] | 35 yo G0P0 | Endometriosis | Laparotomy x 2, left salpingectomy, frozen pelvis; Right hydrosalpinx with partial obstruction | No | FSH/Pergonal (hMG/hCG), hCG trigger | 4 | 4 42–44 h | Fresh | NA | Sigmoid mesentery (E) | ~41 days PT | No | Exploratory Laparotomy | Removal of pregnancy tissue by laparotomy |
Bassil (1991) [24] | 33 yo NA | Male factor | NA | NA | Clomid/hMG, hCG trigger | 6 | 4 NA | Fresh | NA | Posterior uterus, broad ligament (H) | 19Â weeks gestation | No | Laparotomy, right adnexectomy | Delivery of viable twins at 34Â weeks |
Ferland (1991) [25] | 32 yo G4P0030 | DES exposure, secondary infertility | Right salpingectomy, left hydrosalpinx | Tubal ectopic | Long protocol w/GnRH agonist | 7 | 3 Day 2 ET | Fresh | 19,450 | Retroperitoneal (E) | 37Â days PT | Yes | Laparotomy, left salpingectomy | Â |
Ragni (1991) [26] | 32 yo G1P0010 | Pelvic adhesive disease | Right adnexectomy, hysteropexy | Tubal ectopic | Long protocol w/GnRH agonist | 4 | 3 Day 2 ET | Fresh | NA | Right adnexa (H) | 12Â weeks gestation | No | Selective reduction of abdominal pregnancy, laparotomy | Laparotomy for resorbing abdominal pregnancy, SAB of IUP at 16Â weeks |
Balmaceda (1993) [27] | 33 yo G3P1021 | Tubal | Right salpingectomy, left salpingostomy | Tubal Ectopic x2 | Short protocol, w/GnRH agonist | 15 | 4 Day 4 ET | Fresh | 4651 | Abdominal - broad ligament (E) | 30Â days PT | No | Laparoscopy, salpingectomy | Laparoscopic removal of abdominal ectopic, left salpingectomy |
Fisch (1995) [28] | 32 yo G2P0020 | Tubal | Bilateral salpingectomy | Tubal ectopic x2 | Long protocol w/GnRH agonist | 5 | 3 NA | Fresh | NA | Ileum, left uterine cornua (H) | 10Â weeks gestation | Yes | Gastrostoscopy, sigmoidoscopy, Tc scan, angiography, D&C, tagged RBC scan, Laparotomy | Laparotomy for abdominal ectopic, D&C for incomplete AB of IUP |
DelRosario (1996) [29] | 33 yo G1P1001 | Tubal | Breast Cancer | No | NA | NA | 4 NA | Frozen | 563 | Bladder (E) | 75Â days PT | Yes | Methotrexate, laparoscopy | Laparoscopic removal of pregnancy tissue |
Fisch (1996) [11] | 38 yo G2P0020 | Tubal | Laparoscopic Salpingectomy x2, 8th IVF cycle | Tubal ectopic x 2 | Long protocol w/GnRH agonist | 14 | 4 Day 3 ET | Fresh | 1730 | Broad Ligament (E) | 21Â days PT | Yes | Exploratory Laparotomy | Removal of pregnancy tissue by laparotomy |
Moonen-Delarue (1996) [30] | 23 yo G2P0020 | Pelvic adhesive disease | Right salpingectomy | Tubal and abdominal ectopic | NA | NA | NA NA | Fresh | NA | Abdominal - uterine fundus (E) | 28Â weeks | Placental abruption | Laparotomy | Fetal demise of abdominal ectopic @ 28Â weeks |
Pisarska (1998) [31] | 35 yo G2P0020 | Unexplained | NA | No | Long protocol w/GnRH agonist | 9 | 6 NA | Fresh | 6004 | Bladder serosa (H) | 6Â weeks gestation | No | Diagnostic laparoscopy | Laparoscopic removal of ectopic pregnancy (bladder), term delivery of IUP |
Deshpande (1999) [32] | 33 yo G1P0010 | Endometriosis | Endometriosis, left salpingectomy, Patent right tube | No | Long protocol w/GNRH agonist | 8 | 2 Day 3 ET | Fresh | 55,560 | Twin pregnancy in broad ligament (H) | 7Â weeks PT | No | Laparotomy | Removal of twin ectopic pregnancy by laparotomy at 7Â weeks |
Scheiber (1999) [33] | 37 yo G3P0030 | Tubal factor EndometriosisDOR | Salpingostomy, donor oocytes | Tubal ectopic | NA | NA | 2 Day 3 ET | Frozen | NA | Abdominal (H) | 8.5Â weeks PT | No | KCl selective reduction of abdominal pregnancy | Selective reduction of abdominal pregnancy, full term viable IUP |
Dmowski (2002) [34] | 34 yo G0P0 | Tubal | Bilateral Salpingectomy | No | Long protocol w/GnRH agonist | 15 | 3 Day 3 ET | Fresh | 38,635 | Retroperitoneal pancreatic (E) | 41Â days PT | Yes | Laparotomy | Retroperitoneal subpancreatic ectopic removed by laparotomy |
Jain (2002) [35] | 29 yo G0P0 | Unexplained | NA | No | NA | NA | 2 NA | NA | NA | Pouch of Douglas (H) | 9Â weeks PT | NA | Laparotomy at 4w weeks (no IUP seen), selective reduction of ectopic at 13Â weeks | Selective reduction of abdominal ectopic, removal by laparotomy, SAB of IUP |
Cormio (2003) [36] | 30 yo G2P0020 | Tubal | Bilateral salpingectomy | Tubal ectopic x2 | Menotropins, hCG trigger | 7 | 4 Day 3 ET | Fresh | 256,400 | Omentum, uterine fundus (H) | 13Â weeks gestation | No | Laparotomy | Laparotomy for abdominal ectopic; Live IUP delivered at 36Â weeks |
Reid (2003) [37] | 28 yo G5P1041 | Tubal | bilateral salpingectomy | Tubal ectopic x3 | NA | NA | 3 NA | NA | 5500 | Retroperitoneal, iliac bifurcation (E) | 63Â days PT | NA | Laparotomy | Removal of ectopic via laparotomy |
Kitade (2005) [38] | 37 yo G0P0 | Unexplained | NA | No | Long protocol w/GnRH agonist | 12 | 3 Day 3 ET | Fresh | 45,896 | Splenic and Tubal (H) | 34Â days PT (tubal), 46Â day PT (splenic) | Tubal - No, Splenic - Yes | 1) Laparoscopic salpingectomy 2) Exploratory laparotomy | Removal of tubal ectopic by laparoscopy, removal of splenic ectopic by laparotomy (12Â days later) |
Ali (2006) [39] | 35 NA | Tubal | Pelvic adhesions | No | NA | 11 | 1 NA | Fresh | 1524 | Tube with Omental/peritoneal trophoblastic tissue (H) | 3 weeks PT - tubal ectopic; 5 weeks PT – omental tissue | No | Laparoscopic salpingectomy; Laparocopic removal of omental/peritoneal trophoblastic tissue | Removal of tubal and peritoneal/omental pregnancy tissue by 2 laparoscopies |
Apantaku (2006) [40] | 33 G3P1021 | Tubal | Bilateral salpingectomy | Tubal ectopic x2 | NA | NA | 2 NA | Fresh | NA | Right adnexa (E) | 6Â weeks PT | No | Laparoscopy | Laparoscopic removal of pregnancy tissue |
Knopman (2007) [41] | 37 yo G4P0040 | Unexplained | NA | No | GnRH antagonist | 9 | 2 Day 5 ET | Fresh | 1023 | Posterior cul-de-sac (H) | 7Â weeks, nonviable IUP; 9Â weeks ectopic | Yes | Laparoscopy | D&C for non-viable IUP; Laparoscopy for abdominal ectopic |
Shih (2007) [42] | 33 yo G0P0 | Male Factor | Patent tubes | No | Long protocol w/GnRH agonist | 4 | NA NA | Fresh | 901 | Cul-de-sac (E) | 28Â days PT | No | Laparoscopy converted to laparotomy | Removal of pregnancy tissue by laparotomy |
Shojai (2007) [43] | 35 yo G0P0 | Structural, DES exposure | NA | No | NA | NA | 3 NA | NA | NA | Abdominal - uterine fundus (H) | 21Â weeks gestation | No | Laparotomy | Delivery of viable twins at 32Â weeks |
Iwama (2008) [44] | 31 yo G1P0010 | Tubal | Right Salpingectomy for tubal ectopic after IVF, left salpingectomy for hydrosalpinx | Tubal ectopic | NA | NA | 3 Day 3 ET | Fresh | 45, 369 | Inferior Vena Cava/Retroperitoneal (E) | 32Â days PT: PUL; 53Â days PT: retroperitoneal ectopic | Yes | D&C, MTX, Diagnostic laparoscopy, repeat MTX, Exploratory laparotomy | Ruptured retroperitoneal ectopic, removed by laparotomy |
Hyvarinen (2009) [45] | NA NA | NA | NA | NA | NA | NA | NA NA | NA | NA | Abdominal (E) | 30Â weeks gestation | No | Laparotomy | Delivery of viable fetus at 30Â weeks |
Zacche (2011) [46] | 36 G1P1 | Tubal | Bilateral Salpingectomy, PID | No | NA | NA | 2 NA | Fresh | NA | Abdominal (H) | 32Â weeks at Cesarean Delivery | No | Laparotomy, hysterectomy | Viable twin pregnancies at 32Â weeks; Hysterectomy |
Angelova (2015) [47] | 33 NA | Male Factor | Obturated left tube | NA | Short protocol, w/GnRH antagonist | NA | 2 Day 3 ET | Fresh | NA | Abdominal - vesicouterine junction (E) | 23Â days PT | No | Laparoscopy | Laparoscopic removal of pregnancy tissue |
Dalmia (2015) [48] | 37 G1P0010 | EndometriosisTubal factor | Bilateral salpingectomy for hydrosalpinx | NA | NA | NA | NA NA | NA | 21,730 | Left adnexa (E) | 2Â weeks PT | No | Mini-laparotomy | Removal of ectopic via laparotomy |
Koyama (2015) [49] | 32 G5P1 | Male Factor | NA | No | NA | NA | 1 NA | Frozen | 14,800 | Retroperitoneal (E) | 10Â weeks gestation | NA | Laparoscopy | Laparoscopic removal of pregnancy tissue |