Primary hepatic pregnancy: report of a case treated with laparoscopic approach and review of the literature

Thirty-nine cases of hepatic pregnancy have been reported. Abdominal ultrasound plays a key role in the diagnosis of a hepatic localization, and laparoscopy is a feasible approach for surgical treatment.

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Volume 110, Issue 5, Pages 925–931.e1

Authors:

Simone Garzon, M.D., Ricciarda Raffaelli, M.D., Umberto Montin, M.D., Fabio Ghezzi, M.D.

Abstract:

Objective

To report a case of primary hepatic pregnancy complicated by acute hemoperitoneum that was treated with a laparoscopic approach.

Design

Case report and review of the literature.

Setting

Obstetrics and gynecology unit of a university hospital.

Patient(s)

A 37-year-old pregnant woman who presented with vaginal bleeding.

Intervention(s)

Diagnosis by abdominal ultrasound and computed tomography.

Main Outcome Measure(s)

Patient recovery after minimally invasive laparoscopic surgery and monitoring.

Result(s)

A hepatic ectopic pregnancy complicated by hemoperitoneum was diagnosed. The hepatic pregnancy was surgically removed via laparoscopy through a retroperitoneal approach, and the patient's human chorionic gonadotropin level was subsequently monitored. The patient's postoperative course was uneventful, and the serum human chorionic gonadotropin level dropped to zero.

Conclusion(s)

Only 39 cases of hepatic pregnancy have been reported in the literature, making it an exceptional category among abdominal pregnancies. Hepatic localization should be ruled out in cases of unknown pregnancy location. Abdominal ultrasound has a key role detecting hepatic localization and excluding other abdominal implantation sites. Laparoscopic surgery represents a feasible approach for the treatment of first trimester hepatic pregnancies.


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Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.

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