Narrow band imaging and local vasopressin injection aid in successful laparoscopic treatment for abdominal pregnancy in the vesicouterine pouch: A case report

Abstract

  A 31-year-old woman was referred to our hospital for ectopic pregnancy. Transvaginal ultrasonography revealed a fetus in the right adnexal region (crown–rump length 7.1 mm with positive heartbeats). The gestational sac (GS) was implanted on the vesicouterine pouch near the right round ligament; however, no major bleeding was observed. Narrow band imaging (NBI) confirmed superficial neovascularization and avascular lesions. We performed subperitoneal injection of diluted vasopressin (0.2 U/mL) around the lesion, to prevent major bleeding, and excised the GS and villi using forceps, without any significant bleeding.

Conclusion: NBI-guided endoscopy can confirm the growth of vessels around the ectopic pregnancy, and injection of diluted vasopressin prevents severe bleeding and facilitates complete laparoscopic removal of the ectopic tissue.