title: Early abdominal ectopic pregnancies: a systematic review of the literature.
abstract: OBJECTIVE
  To define abdominal ectopic pregnancy outcomes by both location and treatment.
  
  
  METHODS
  Literature review of abdominal pregnancies from 1965 to August of 2009. Ectopic pregnancy exclusions were interstitial, tubal, cervical, ovarian, or those beyond 20 weeks at diagnosis/treatment.
  
  
  RESULTS
  There were 511 cases identified with 225 meeting the inclusion criteria. There were 7 maternal deaths (3.0%) with 18 (8%) of the early abdominal ectopic pregnancies occurring with an intrauterine device in place. Mean gestational age at the time of treatment was 10 weeks 0 days and mean maternal age was 29.7 years. The average blood loss associated with treatment was 1,450 ml. The top three sites of early abdominal ectopic pregnancies were pouches around the uterus (24.3%), serosal surface of the uterus and tubes (23.9%), and multiple sites (12.8%). Primary surgical management was performed in 208 cases (87.8%). Nonsurgical adjuvant or primary therapy included intramuscular methotrexate, intralesional methotrexate, intracardiac KCl, and artery embolization.
  
  
  CONCLUSIONS
  Abdominal pregnancies should be considered in all patients until an intrauterine location can be confirmed. Understanding treatment options by pregnancy location may be helpful in the management of this potentially life-threatening condition.
authors.affiliation: Department of Obstetrics and Gynecology, Naval Hospital Lemoore, Lemoore, CA, USA.
authors.forename: Aaron
authors.initials: A
authors.lastname: Poole
authors.forename: David
authors.initials: D
authors.lastname: Haas
authors.forename: Everett F
authors.initials: EF
authors.lastname: Magann
mesh_terms: D034861:Abdominal Wall; D000290:Adnexa Uteri; D016063:Blood Loss, Surgical; D004064:Digestive System; D005260:Female; D005865:Gestational Age; D006801:Humans; D007434:Intrauterine Devices; D008428:Maternal Mortality; D010537:Peritoneum; D011247:Pregnancy; D011269:Pregnancy, Abdominal / Q000209:etiology / Q000401:mortality* / Q000628:therapy*; D012187:Retroperitoneal Space; D014599:Uterus