{
    "abstract": "Abdominal ectopic pregnancy is a rare complication with high maternal and perinatal morbimortality. The objective was to present the multidisciplinary management of an advanced abdominal ectopic pregnancy associated with COVID-19, and a review of the literature.\n33-year-old multiparous patient with an abdominal ectopic pregnancy of 34 weeks, diagnosed by ultrasound at 27 weeks. 6 days prior to admission she started with diffuse abdominal pain. She was referred with positive RT-PCR test for SARS-CoV-2, without respiratory symptoms. CT scan reported probable infiltration of bowel loops, bladder roof and right ureter. Abdominal ultrasound corroborated the diagnosis and showed absence of involvement of iliac and ureteral vessels. MRI reported vascular contribution of the placental bed dependent on the right iliac artery and distal branches of the superior mesenteric artery. Exploratory laparotomy was performed, finding a live fetus in the abdominal cavity with a ruptured amnion, weight 2385 g, Apgar 5/8; placenta with implantation in the broad ligament, salpinges, ovary, bladder roof, infundibulopelvic ligament and appendix. A total abdominal hysterectomy was performed with right salpingo-oophorectomy, left salpingectomy and appendectomy. The total bleeding was of 3000 mL and there was a favorable post-surgical evolution.\nAbdominal ectopic pregnancy represents a challenge in obstetrics. Offering a multidisciplinary management allows to have a favorable outcome.\nel embarazo ect\u00f3pico abdominal es una complicaci\u00f3n poco frecuente con elevada morbimortalidad materna y perinatal. El objetivo fue presentar el manejo multidisciplinario de un embarazo ect\u00f3pico abdominal avanzado asociado a COVID-19 y hacer una revisi\u00f3n de la literatura.\npaciente multigesta de 33 a\u00f1os, con embarazo ect\u00f3pico abdominal de 34 semanas, diagnosticado por ultrasonido a las 27 semanas. Seis d\u00edas antes inici\u00f3 con dolor abdominal difuso. Fue referida con prueba RT-PCR para SARS-CoV-2 positiva, sin s\u00edntomas respiratorios. La tomograf\u00eda report\u00f3 probable infiltraci\u00f3n a asas intestinales, techo vesical y uretero derecho. El ultrasonido abdominal corrobor\u00f3 diagn\u00f3stico y mostr\u00f3 ausencia de compromiso de vasos iliacos y ureteros. La resonancia magn\u00e9tica report\u00f3 aporte vascular del lecho placentario dependiente de arteria iliaca derecha y ramos distales de mesent\u00e9rica superior. Se hizo laparotom\u00eda exploradora y se encontr\u00f3 al feto vivo en cavidad abdominal con amnios roto, peso 2385 gramos, Apgar 5/8; placenta con implantaci\u00f3n en ligamento ancho, salpinge, ovario, techo vesical, ligamento infundibulop\u00e9lvico y ap\u00e9ndice. Se realiz\u00f3 histerectom\u00eda total abdominal con salpingooforectom\u00eda derecha, salpingectom\u00eda izquierda y apendicectom\u00eda. Hubo un sangrado total de 3000 mL y una evoluci\u00f3n postquir\u00fargica favorable.\nel embarazo ect\u00f3pico abdominal representa un reto en la obstetricia. Ofrecer un manejo multidisciplinario permite tener un resultado favorable.",
    "authors": [
        {
            "affiliation": "Instituto Mexicano del Seguro Social, Hospital de Gineco Obstetricia No. 4 \"Luis Castelazo Ayala\", Servicio de Complicaciones de la Segunda Mitad del Embarazo. Ciudad de M\u00e9xico, M\u00e9xico.",
            "firstname": "Maritza",
            "initials": "M",
            "lastname": "Garc\u00eda-Espinosa"
        },
        {
            "affiliation": "Instituto Mexicano del Seguro Social, Hospital de Gineco Obstetricia No. 4 \"Luis Castelazo Ayala\", Servicio Ginecolog\u00eda Oncol\u00f3gica. Ciudad de M\u00e9xico, M\u00e9xico.",
            "firstname": "Abisa\u00ed",
            "initials": "A",
            "lastname": "Monta\u00f1o-Mart\u00ednez"
        },
        {
            "affiliation": "Instituto Mexicano del Seguro Social, Hospital de Gineco Obstetricia No. 4 \"Luis Castelazo Ayala\", Departamento de Tococirug\u00eda. Ciudad de M\u00e9xico, M\u00e9xico.",
            "firstname": "Mar\u00eda de la Caridad",
            "initials": "MC",
            "lastname": "Carranco-Salinas"
        },
        {
            "affiliation": "Instituto Mexicano del Seguro Social, Hospital de Gineco Obstetricia No. 4 \"Luis Castelazo Ayala\", Servicio Ginecolog\u00eda Oncol\u00f3gica. Ciudad de M\u00e9xico, M\u00e9xico.",
            "firstname": "Germ\u00e1n",
            "initials": "G",
            "lastname": "Maytorena-C\u00f3rdova"
        },
        {
            "affiliation": "Instituto Mexicano del Seguro Social, Hospital de Gineco Obstetricia No. 4 \"Luis Castelazo Ayala\", Departamento de Tococirug\u00eda. Ciudad de M\u00e9xico, M\u00e9xico.",
            "firstname": "Israel",
            "initials": "I",
            "lastname": "Bravo-P\u00e9rez"
        },
        {
            "affiliation": "Instituto Mexicano del Seguro Social, Hospital de Gineco Obstetricia No. 4 \"Luis Castelazo Ayala\", Divisi\u00f3n de Obstetricia. Ciudad de M\u00e9xico, M\u00e9xico.",
            "firstname": "Felipe",
            "initials": "F",
            "lastname": "Caldi\u00f1o-Soto"
        }
    ],
    "conclusions": "Abdominal ectopic pregnancy represents a challenge in obstetrics. Offering a multidisciplinary management allows to have a favorable outcome.",
    "copyrights": "Licencia CC 4.0 (BY-NC-ND) \u00a9 2024 Revista M\u00e9dica del Instituto Mexicano del Seguro Social.\nLicencia CC 4.0 (BY-NC-ND) \u00a9 2024 Revista M\u00e9dica del Instituto Mexicano del Seguro Social.",
    "doi": "10.5281/zenodo.12668180",
    "journal": "Revista medica del Instituto Mexicano del Seguro Social",
    "keywords": [
        "Hysterectomy",
        "Pregnancy, Abdominal",
        "Pregnancy, Ectopic"
    ],
    "methods": null,
    "publication_date": "2024-11-23",
    "pubmed_id": "39578056",
    "results": null,
    "title": "[Abdominal ectopic pregnancy: case report and review of the literature].",
    "xml": "<Element 'PubmedArticle' at 0x788503d4a200>"
}