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.
Cohen et al. (Thu,) studied this question.