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Updated: Aug 24, 2026
Deep Neuromuscular Blockade Leads to a Larger Intraabdominal Volume During Laparoscopy
Published on: June 25, 2013
Minimally invasive management of an advanced abdominal pregnancy
Jamal Rahaman1, Richard Berkowitz, Harold Mitty
1Department of Obstetrics, Gynecology, and Reproductive Sciences, Mount Sinai Medical Center, New York, New York 10029, USA. jamal.rahaman@mssm.edu
Background:
Advanced abdominal pregnancy is a rare, life-threatening condition that presents a number of challenges.
Case:
A 29-year-old primigravida with 10 years of secondary infertility and a previous tuboplasty had a 21-week abdominal pregnancy treated with preoperative arterial embolization before laparoscopically assisted fetal delivery. Postoperatively, 4 cycles of methotrexate were administered at 50 mg/m2 intramuscularly every 3 weeks for the retained abdominal placenta. Subsequent spontaneous conception occurred, and a live, full-term infant was delivered by cesarean delivery 17 months later. No adverse sequelae were found during long-term follow-up.
Conclusion:
This report demonstrates successful minimally invasive management of an advanced abdominal pregnancy with a multimodal approach that included preoperative arterial embolization, laparoscopically assisted delivery, and judicious use of postoperative methotrexate.
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