Is it possible to have a pregnancy in the liver? As eerie as it might sound, recently India has registered its first case of intrahepatic ectopic pregnancy, an uncommon and life-threatening condition. In this condition, the fertilised egg is implanted in the liver as opposed to the uterus. Medical professionals are referring to it as one of the most bizarre medical cases in history.
To know more about what this condition is, how it occurs, and what possible treatment options are, Dr Neha Negi, Associate Director, Obstetricians & Gynaecologists, Apollo Hospitals Lucknow, shared insights.
What Is an Intrahepatic Ectopic Pregnancy?
Ectopic pregnancy happens when an egg gets fertilised and grows outside of the uterus and is usually in the fallopian tubes. However, the rare occurrence of an embryo being planted in other parts of the body, such as the liver, has been reported in India, specifically in Uttar Pradesh. This pregnancy in the liver has been termed ‘intrahepatic ectopic pregnancy’, and there are fewer than five such cases recorded worldwide.
The intrahepatic ectopic pregnancy is unheard of. Liver is a highly vascular organ, and when the implantation is done in the liver, then there can be profuse internal bleeding, and it may be life-threatening when not diagnosed early,” says Dr Negi.
India’s First Liver Pregnancy News
In the presented case in India, a 25-year-old woman presented to the hospital with abdominal pain and irregular bleeding. On the first ultrasound, there was no indication of a uterine pregnancy. However, as expected, something rather shocking indicated itself on advanced imaging, a gestational sac deep in her liver in the left lobe.
This involved a multi-disciplinary team consisting of obstetricians, radiologists, and surgeons to ensure a safe termination of pregnancy and control of internal bleeding. The patient is now in recovery.
Liver Ectopic Pregnancy Symptoms
According to Dr Negi, “Such cases can occur when a fertilised egg enters the fallopian tube and moves to the cavity of the abdomen and attaches itself to one of the organs’ surfaces, such as the liver.” It is an abdominal pregnancy, and the rarest form of implantation is in the liver.
Factors that may increase risk include:
- Prior ectopic pregnancies
- Pelvic inflammatory disease
- Assisted reproductive technologies (IVF)
- Tubal damage or surgery
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Why Is Intrahepatic ectopic pregnancy Risky?
Intrahepatic pregnancy is extremely risky as the blood vessels are dense in the liver. In case an implantation in the area takes place, it may burst and result in colossal internal bleeding. This poses a risk since the diagnosis can easily be delayed due to the nature of the location being so uncommon.
Dr Negi explained further and said, “The patients tend to present to the emergency with non-specific abdominal pain and inconsistent bleeding, hence early detection is difficult. It requires a high index of suspicion.”
Doctor Explains Intrahepatic Pregnancy: Treatment and Diagnosis ![signs of ectopic pregnancy]()
According to Dr Negi, it is diagnosed based on:
- Transvaginal ultrasound.
- Complete abdominal ultrasound.
- CT or MRI scans to locate the gestational sac.
- Blood tests for pregnancy hormone levels (hCG)
Dr Negi told, "Treatment depends on the stage and severity", This includes:
- Surgical removal through laparoscopy or laparotomy.
- Blood transfusions are needed if there’s internal bleeding.
- Post-op monitoring to ensure hCG levels return to normal
Dr Negi said, “There are non-surgical treatments using methotrexate, a chemotherapy medication, in a pregnancy tissue dissolution-only treatment that is possible in certain scenarios, but not when the pregnancy becomes implanted in such a risky location, such as the liver.”
What Does This Mean for Women?
Intrahepatic ectopic pregnancy is quite rare but indicates the necessity of early prenatal examinations. In case you have abdominal pains, which are sharp and may occur along with unusual bleeding, especially if you are pregnant, then you should not wait to seek medical assistance,” recommended Dr Negi.
She urges patients and general practitioners to consider non-uterine ectopic pregnancies when patients experience symptoms of pregnancy, but an obstetric ultrasound shows an empty uterus.
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Bottom Line: Rare but Caution is Needed
Ectopic intrahepatic pregnancy is considered to be one of the most uncommon medical conditions known to medical science. The case in India is the first of its kind. It acts as a wake-up call to the medical fraternity as well as expectant mothers on what can happen concerning ectopic pregnancies in uncommon places, a medical nightmare. With the help of the prompt detection of the problem and professional treatment, the patient managed to surmount a life-threatening condition. However, the incident highlights that more awareness, better imaging, and better intervention are needed.