Broad ligament ectopic pregnancy following in-vitro fertilisation in a patient with previous bilateral salpingectomy.

摘要

A 33-year-old para 1+2 woman underwent in-vitro fertilisation (IVF) and embryo transfer (ET) in a private clinic. She had conceived naturally before and this resulted in a normal delivery. In the ensuing 9 years, she had two laparotomies on account of first a right ampullary ectopic pregnancy and then a left ruptured ectopic pregnancy. A salpingectomy was done on each occasion.She was subsequently referred for sub-fertility treatment. She went through one IVF cycle, following which two embryos were replaced. A transvaginal ultrasound scan done 6 weeks after the embryo transfer showed an empty endometrial cavity. There was however, a gestation sac containing a viable fetus (CRL 3 mm - 6"1"1 weeks) in the right adnexal region. This was suggestive of a right ectopic pregnancy.She underwent a laparoscopy in our hospital. There was a 2 cm ectopic pregnancy in her right broad ligament just below the remnant of her right tube (Figure 1). This was excised laparoscopically with the aid of surgiswip sutures and monopolar diathermy. She had extensive abdominal adhesions.Her postoperative course was largely uneventful. Histologic examination confirmed the presence of a broad ligament ectopic pregnancy. She was well at 6 weeks follow-up.