title: Minimally invasive management of an advanced abdominal pregnancy.
abstract: BACKGROUND
  Advanced abdominal pregnancy is a rare, life-threatening condition that presents a number of challenges.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Obstetrics, Gynecology, and Reproductive Sciences, Mount Sinai Medical Center, New York, New York 10029, USA. jamal.rahaman@mssm.edu
authors.forename: Jamal
authors.initials: J
authors.lastname: Rahaman
authors.forename: Richard
authors.initials: R
authors.lastname: Berkowitz
authors.forename: Harold
authors.initials: H
authors.lastname: Mitty
authors.forename: Sreedhar
authors.initials: S
authors.lastname: Gaddipati
authors.forename: Barry
authors.initials: B
authors.lastname: Brown
authors.forename: Farr
authors.initials: F
authors.lastname: Nezhat
mesh_terms: D000328:Adult; D002585:Cesarean Section; D003131:Combined Modality Therapy; D036861:Delivery, Obstetric / Q000379:methods; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D007273:Injections, Intramuscular; D010535:Laparoscopy; D008279:Magnetic Resonance Imaging; D008727:Methotrexate / Q000008:administration & dosage; D018457:Placenta, Retained / Q000628:therapy; D011182:Postoperative Care; D011247:Pregnancy; D011269:Pregnancy, Abdominal / Q000175:diagnosis / Q000628:therapy*
chemical_list: D008727:Methotrexate