Obstet Gynecol Sci.  2017 Jul;60(4):391-395. 10.5468/ogs.2017.60.4.391.

Successful laparoscopic management of uterine serosal pregnancy

• Seo GH
• Lee HJ
• Jang JH
• Choi MC
• Lee C
• Kim G

• KMID: 2386284
• DOI: http://doi.org/10.5468/ogs.2017.60.4.391

Abstract

Uterine serosal pregnancy is an extremely rare form of ectopic pregnancy. This is a report of a 35-year-old primigravida woman who was diagnosed with uterine serosal pregnancy via laparoscopic intervention. A 35-year-old woman (gravida 1, para 0) was referred from a local clinic for a ruptured left tubal pregnancy at amenorrhea 5+0 weeks with elevated serum beta human chorionic gonadotropin (16,618 mIU/mL). A pregnancy on the left posterior wall of the uterine serosa was diagnosed during the operation and successfully treated with laparoscopic surgery as a conservative management strategy to enable fertility preservation. With the advantages of ultrasonography and laparoscopy, an early diagnosis of a primary abdominal pregnancy located on the left posterior wall of the uterine serosa was made, prior to the occurrence of severe intra-abdominal massive hemorrhage, which was then treated laparoscopically as a conservative management strategy enabling the preservation of fertility.

Keyword

Pregnancy, abdominal; Pregnancy, ectopic; Uterine serosal pregnancy

MeSH Terms

Adult
Amenorrhea
Chorionic Gonadotropin
Early Diagnosis
Female
Fertility
Fertility Preservation
Hemorrhage
Humans
Laparoscopy
Pregnancy*
Pregnancy, Abdominal
Pregnancy, Ectopic
Pregnancy, Tubal
Serous Membrane
Ultrasonography
Chorionic Gonadotropin

Figure

• 

  Fig. 1 (A) Preoperative two-dimensional transvaginal sonogram revealed a gestational sac (G-sac) that was separated from the uterus, with a certain amount of hemoperitoneum, suggesting the presence of an ectopic pregnancy. (B) Three-dimensional transvaginal sonogram revealed a 1.8-cm mass located adjacent to the left cornus, clearly outside the endometrium (EM).

• 

  Fig. 2 Laparoscopic and pathologic findings. (A) An approximately 2.0-cm ruptured ectopic mass at the left posterior serosa of the uterus was observed. Both adnexae were grossly normal. (B) After removing the ectopic mass, chromopertubation was successfully performed on both tubes, and the scar was meticulous sutured. (C) Microscopic photograph of trophoblastic villi removed from the uterine serosa (H&E, ×200).

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