Successful management of a rare intra-abdominal pregnancy.

VTV.vn - A rare case of abdominal ectopic pregnancy was successfully treated by doctors at Hong Ngoc Phuc Truong Minh General Hospital, preventing severe bleeding and saving the patient's life in time.

Ms. NTK ( Hanoi ) visited Hong Ngoc Phuc Truong Minh General Hospital for examination due to dull abdominal pain following a missed period. Beta HCG test results showed a concentration of 4,857.44 mIU/ml; however, initial ultrasound did not detect a gestational sac in the uterus or adnexa on either side.

Noticing an abnormality, the team continued with a more in-depth ultrasound and discovered a 12x16 mm mass located in the posterior cul-de-sac. After consultation, the doctors diagnosed the patient with abdominal ectopic pregnancy, a very rare form of ectopic pregnancy.

According to doctors, abdominal ectopic pregnancies account for only about 1% of all ectopic pregnancies. Unlike the more common cases that implant in the fallopian tube, abdominal pregnancies have an unusual implantation location, making them prone to late diagnosis and posing many dangerous complications such as abdominal hemorrhage, acute blood loss, damage to adjacent organs such as the intestines, bladder, and large blood vessels, and even life-threatening hemorrhagic shock.

Ultrasound images revealed an ectopic pregnancy. (Source: Hong Ngoc General Hospital)

" In this case, the gestational sac was located deep within the pelvic cavity, close to the rectum, and there was a risk of involvement of the proliferative vascular system around the pelvis. Although the gestational sac had not ruptured at the time of detection, the risk of progression was very high if intervention was delayed. When the gestational sac detaches or ruptures suddenly, the patient could experience massive internal bleeding and be life-threatening in a short time, " said Dr. Nguyen Van Xuyen, Head of the Gynecology and Breast Unit.

The hospital activated a multidisciplinary consultation process involving Obstetrics and Gynecology, Anesthesia and Resuscitation, and the laparoscopic surgery team to develop the safest management plan for the patient and assess potential risks during the surgery. Doctors evaluated the extent of invasiveness of the pregnancy, the possibility of involvement of the rectum and pelvic blood vessels, and prepared a blood bank in case of significant bleeding.

Simultaneously, the surgical team developed multiple treatment scenarios, including a plan to switch to open surgery if uncontrollable blood loss occurred or if the pregnancy became complicated. All necessary hemostatic equipment and emergency procedures were fully prepared before the surgery.

Regarding anesthesia and resuscitation, the patient undergoes thorough pre-anesthesia assessment, continuous hemodynamic monitoring, and resuscitation plans are prepared to ensure maximum safety throughout the surgical procedure.

Laparoscopic removal of the ectopic pregnancy while preserving the uterus for the patient.

Approximately 30 minutes after the examination, the patient was scheduled for laparoscopic removal of the ectopic pregnancy. This minimally invasive method allows doctors to clearly observe the pelvic region and better control the damage in rare cases of ectopic pregnancy.

The surgical team performing the laparoscopic removal of the fetal mass (Source: Hong Ngoc General Hospital)

During the surgery, the team carefully dissected the fetal mass layer by layer, while closely monitoring the blood vessels around the lesion to minimize the risk of bleeding. Simultaneously, the anesthesia and resuscitation team continuously monitored the patient's blood pressure, pulse, and hemodynamic status. Thanks to thorough risk assessment before surgery and comprehensive preparation of treatment scenarios, the surgery proceeded smoothly, and the fetal mass was safely removed without any reported complications.

Image of the gestational sac on the endoscopy screen (Source: Hong Ngoc General Hospital)

Postoperatively, the patient's hemodynamics were stable, and no complications were observed. Postoperative monitoring indicators, including blood pressure and beta HCG levels, all showed positive developments. After only one day, Ms. K was pain-free and able to resume almost normal activities.

Doctors recommend that women with delayed menstruation accompanied by abdominal pain and abnormal bleeding should seek medical attention early for ultrasound and timely monitoring of early pregnancy beta HCG levels. In rare cases of ectopic pregnancy, early detection and management at a facility with full resuscitation and surgical specialties are particularly important in reducing the risk of complications and preserving the patient's life.

With nearly 30 years of specialized healthcare experience, Hong Ngoc General Hospital is currently the only private medical facility in Vietnam to achieve the international quality certification ACHSI (Australian Council on Healthcare Standards International) and is recognized for safe surgical procedures according to the Royal College of Surgeons (RCS) standards. This is considered a guarantee of Hong Ngoc's professional competence, patient safety control procedures, and quality of treatment according to international standards.

Source: https://vtv.vn/xu-tri-thanh-cong-thai-trong-o-bung-hiem-gap-100260602114824319.htm