Obstet Gynecol Sci.  2013 Nov;56(6):404-407. 10.5468/ogs.2013.56.6.404.

Full term broad ligament pregnancy through a Cesarean scar

• Rudra S
• Gupta S
• Taneja BK
• Gupta R

• KMID: 1500375
• DOI: http://doi.org/10.5468/ogs.2013.56.6.404

Abstract

A broad ligament pregnancy is an extremely rare condition. Diagnosis is often missed and finally made during laparotomy. We present a case which remained undiagnosed throughout her pregnancy till she reached term and unfortunately had intrauterine foetal demise when she reported to our hospital. On clinical suspicion, ultrasound and magnetic resonance imaging evaluation was done which picked up the diagnosis of abdominal pregnancy. On laparotomy a broad ligament pregnancy was found with a rent in the previous Cesarean scar towards the gestational sac in the broad ligament.

Keyword

Broad ligament; Ectopic pregnancy; Ultrasonography

MeSH Terms

Rare Diseases
Broad Ligament*
Cicatrix
Diagnosis
Female
Gestational Sac
Laparotomy
Magnetic Resonance Imaging
Pregnancy
Pregnancy, Abdominal
Pregnancy, Ectopic*
Ultrasonography

Figure

• 

  Fig. 1 (A) Magnetic resonance imaging picture of pelvis showing uterus on left side and fetus on right side. Placenta medial to fetus. (B) Magnetic resonance imaging picture of pelvis showing a breach in the lower segment of uterus opening into the fetal sac.

• 

  Fig. 2 (A) Intraoperative photograph showing amniotic sac pushing the uterus to the left. Round ligament stretched over the amniotic sac. (B) Intraoperative photograph showing the cavity occupied by amniotic sac and rent in the anterior wall of the lower segment of uterus. (C) Photograph of postoperative specimen of uterus with a rent in the anterior wall lower segment. (D) Photograph showing full term extracted fetus with placenta.

Reference

1. Vierhout ME, Wallenburg HC. Intraligamentary pregnancy resulting in a live infant. Am J Obstet Gynecol. 1985; 152:878–879.

2. Sheela CN, Mhaskar A, Karanth S. Advanced intraligamentary pregnancy resulting in a live birth. J Obstet Gynecol India. 2011; 57:548–549.

3. Singh U, Singh N, Sankhwar P. Full-term viable broad ligament pregnancy surgically managed with favorable feto-maternal outcome. J Obstet Gynecol India. 2012; 62:23–24.

4. Akhtar N. Ectopic pregnancy and full term live birth: a case report. J Postgrad Med Inst. 2011; 25:181–182.

5. Damario MA, Rock JA. Ectopic pregnancy. In : Rock JA, Jones HW, editors. Te Linde's operative gynaecology. Philadelphia, PA: Lippincott Williams & Wilkins;2008. p. 798–842.

6. Guo S, Dipietro LA. Factors affecting wound healing. J Dent Res. 2010; 89:219–229.

7. Franz MG, Steed DL, Robson MC. Optimizing healing of the acute wound by minimizing complications. Curr Probl Surg. 2007; 44:691–763.

8. Dahab AA, Aburass R, Shawkat W, Babgi R, Essa O, Mujallid RH. Full-term extrauterine abdominal pregnancy: a case report. J Med Case Rep. 2011; 5:531.

9. Onan MA, Turp AB, Saltik A, Akyurek N, Taskiran C, Himmetoglu O. Primary omental pregnancy: case report. Hum Reprod. 2005; 20:807–809.

10. Kim MJ, Bae JY, Seong WJ, Lee YS. Sonographic diagnosis of a viable abdominal pregnancy with planned delivery after fetal lung maturation. J Clin Ultrasound. 2012; [Epub]. http://dx.doi.org/10.1002/jcu.22010.

11. Martin JN Jr, Sessums JK, Martin RW, Pryor JA, Morrison JC. Abdominal pregnancy: current concepts of management. Obstet Gynecol. 1988; 71:549–557.