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2009-08-28-13 Limb-body wall complex in ectopic pregnancy © Cuillier www.thefetus.net/

Limb-body wall complex in ectopic pregnancy 

Fabrice Cuillier, MD.

Department of Gynecology, Felix Guyon Hospital, 97400 Saint-Denis, Reunion Island, France.

 

Case report

 

A 26 year-old (G3P2) with unremarkable history, presented to our department for pelvic pain and 10-week long amenorrhea. A transvaginal ultrasonography was done and found an ectopic pregnancy within her left uterine tube accompanied with hemoperitoneum. The finding of the ectopic pregnancy was characterized by several remarkable features:

  • The embryo was still alive with an omphalocele 15x10 mm, the urinary bladder could not be seen;
  • Sacral meningocele of the embryo could be seen;
  • The lower limbs was kept in an abnormal position; 
  • 3D ultrasound confirmed the omphalocele of the ectopic embryo;

A laparoscopy was done and a hemoperitoneum (500 ml) found, with ectopic pregnancy within the left fallopian tube. Left salpingectomy was done and the pathologist found the embryo with the anterior abdominal defect within the tube. Adhesive amniotic bands were attaching around the abdominal defect. Rachischisis was also present.

Our final diagnosis was the limb-body wall complex in the ectopic embryo.

Images 1, 2: The image 1 shows an ectopic embryo within the left fallopian tube (the left part of the image) and hemoperitoneum surrounding the uterus (the right part of the image). The image 2 shows the uterus with no embryonal structures within its cavity.

 

Images 3, 4: The images show an omphalocele of the ectopic embryo within the left fallopian tube.

 

Images 5, 6: The image 5 shows the ectopic embryo with sacral meningocele. The image 6 shows the lower part of the ectopic embryo with an amniotic band (fingers) and abnormally positioned lower limbs.

 

Image7: The image represents a 3D scan of the ectopic embryo with the omphalocele.

Video 1: The video shows the ectopic pregnancy within the left fallopian tube. The findings described in previous images can be seen - omphalocele of the ectopic embryo, sacral meningocele, abnormally positioned lover extremities and the amniotic band attaching the lover part of the embryo.

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