Advanced extrauterine pregnancy

An advanced extrauterine pregnancy (AEP) is defined as one that has implanted outside the endometrial cavity on any of the surrounding reproductive organs, intraabdominal organs, and/or peritoneum, and has survived to 20 weeks of gestation or more. Advanced extrauterine pregnancies are a rare complication and are highly associated with maternal and fetal morbidity and mortality. Ectopic pregnancies at any gestational age account for 9% of pregnancy related deaths,¹and the risk of maternal death increases with gestational age. Typically, AEP is classified by two factors: (1) the location of the gestation, and (2) whether the site of implantation is primary or secondary. The latter most commonly occurs in the case of a tubal pregnancy that ruptures or extrudes through the fimbriated end and implants on the surrounding tissue, leaving evidence of a damaged tube and a concurrent pregnancy in a different location.^2,3The common sites for AEP are abdominal, ovarian, intraligamentary and rudimentary uterine horn.