Management of a Uterosacral Ligament Ectopic Pregnancy With Presence of an Intrauterine Device.

BACKGROUND

Ectopic pregnancy outside of the fallopian tubes is rare and increases the risk of severe maternal morbidity. Extratubal pregnancies frequently pose diagnostic challenges. We describe a case of an ectopic pregnancy implanted on the uterosacral ligament.

CASE: A 30-year-old primigravid patient with an intrauterine device (IUD) presented for management of an ectopic pregnancy without a clearly understood implantation site after an unsuccessful laparoscopic salpingo-oophorectomy at another facility. Repeat laparoscopy identified the pregnancy implanted on the left uterosacral ligament. Pathology confirmed pregnancy tissue, and the patient's β-hCG decreased appropriately.

CONCLUSION

In the presence of an IUD, serial monitoring is imperative given the high risk of ectopic pregnancy. Ectopic pregnancy management requires careful follow-up of pathology and serial β-hCG. Meticulous intraoperative evaluation can help avoid reoperation.