# Management of a Uterosacral Ligament Ectopic Pregnancy With Presence of an Intrauterine Device

## TL;DR

A rare case of ectopic pregnancy on the uterosacral ligament was successfully managed in a patient with an IUD through careful surgical and hormonal monitoring.

## Contribution

This case highlights the importance of meticulous surgical evaluation and serial β-hCG monitoring in managing rare ectopic pregnancies with an IUD.

## Key findings

- Ectopic pregnancy was confirmed on the uterosacral ligament after repeat laparoscopy.
- Serial β-hCG monitoring showed appropriate decline post-surgery.
- Intraoperative evaluation helped avoid the need for reoperation.

## Abstract

Extratubal pregnancies are difficult to diagnose and require careful management and follow-up.

Ectopic pregnancy outside of the fallopian tubes is rare and increases the risk of severe maternal morbidity. Extratubal pregnancies frequently pose diagnostic challenges. We describe a case of an ectopic pregnancy implanted on the uterosacral ligament.

A 30-year-old primigravid patient with an intrauterine device (IUD) presented for management of an ectopic pregnancy without a clearly understood implantation site after an unsuccessful laparoscopic salpingo-oophorectomy at another facility. Repeat laparoscopy identified the pregnancy implanted on the left uterosacral ligament. Pathology confirmed pregnancy tissue, and the patient's β-hCG decreased appropriately.

In the presence of an IUD, serial monitoring is imperative given the high risk of ectopic pregnancy. Ectopic pregnancy management requires careful follow-up of pathology and serial β-hCG. Meticulous intraoperative evaluation can help avoid reoperation.