EMBARAZO ECTÓPICO HEPÁTICO: REPORTE DE CASO

Abstract

Ectopic pregnancy (EE) refers to the implantation of the fertilize oocyte outside the endometrium, with abdominal pregnancy being one of its most uncommon forms, where the fetus implants in the abdominal cavity. The incidence of EE worldwide is between 1 and 2%, with a similar percentage reported in Peru. Abdominal ectopic pregnancy is critical, since maternal mortality is 7.7 times higher than in tubal pregnancies and 90 times higher than in intrauterine pregnancies.

Abdominal ectopic pregnancies can be classified as primary and secondary, depending on whether fertilization occurs in the abdominal organs or results from a previous ectopic implantation. Diagnosing abdominal EE requires high clinical suspicion, since the symptoms are nonspecific.

To the treatment abdominal EE, there are three approaches: medical, surgical and combined. Surgical intervention is the most common due to the high vascularization in the implantation sites. If the fetus is viable, monitoring and possible surgery delay are suggested; but if it is dead, surgery is recommended to avoid further complications. Furthermore, the management of the placenta in these cases is delicate, since an incomplete extraction can cause serious hemorrhagic complications, and it is often preferable to use combined treatment by keeping it in situ and using methotrexate in situ or postsurgerly.