Diagnosis and management of primary hepatic pregnancy: literature review of 31 cases
To summarize the appropriate diagnostic methods and therapeutic options for primary hepatic pregnancy (PHP).
Literature searches were performed in Pubmed, Web of Science, Cochrane Library and Embase databases (1956–2017), using the following search terms: primary hepatic pregnancy, hepatic pregnancy, liver pregnancy, hepatic ectopic pregnancy and intrahepatic pregnancy. Further literature was confirmed through cross-referencing.
Thirty-one cases were reviewed and collected. The site mostly described in literatures is the right lobe of liver (93.5%). Main symptoms of PHP included abdominal pain (77.4%), amenorrhea (45.2%), acuteperitonism (32.3%), shock (25.8%) and vomit (16.1%). Majority of patients (83.9%) were treated by laparotomy. Less-invasive approaches (16.1%) such as laparoscopy or combination of postoperative injection of methotrexate were used less frequently. The outcome was acceptable at the end of the follow-up period in ten cases (1–72 months) and the recovery rate was 96.7%. One patient died and other complications were noted in three patients during the postoperative period.
The clinical diagnosis of PHP can be settled up by comprehensive analysis of serum HCG levels, ultrasound and imaging. The analysis should be assessed carefully before therapeutic procedure. Invasive methods should be preferential. Less-invasive approaches can be selected when the patients have stable hemodynamics and non-acute abdomen.
KeywordsPrimary hepatic pregnancy Hepatic pregnancy Liver pregnancy Hepatic ectopic pregnancy Intrahepatic pregnancy
JW: data collection, data analysis, manuscript writing. WF and ZL: data collection. ZS and SL: data analysis. XJ and ST: manuscript writing, supervision.
This study was funded by National Natural Science Foundation of China (Grant no. 81602088), Health and Family Planning Commission Research Project of Heilongjiang Province (Grant No. 2016-049), Heilongjiang Postdoctoral Science Foundation (Grant No. LBH-Z16096), Innovative Science Foundation of Harbin Medical University (Grant No. 2016LCZX09), China Postdoctoral Science Foundation (Grant No. 2017M621305) and Wu Jieping Medical Foundation (Grant No. 320.6750.1245).
Compliance with ethical standards
Conflict of interest
We declare that we have no conflict of interest.
This article does not contain any studies with human participants or animals performed by any of the authors.
- 10.Luwuliza-Kirunda JM (1978) Rrimary hepatic pregnancy case report. Acta Obstet Gynecol Scand 66(6):563–564Google Scholar
- 18.Shippey SH, Bhoola SM, Royek AB, Long ME (2007) Diagnosis and management of hepatic ectopic pregnancy. Obstet Gynecol 109(2 Pt2):544–546. https://doi.org/10.1097/01.AOG.0000247293.32523.c3 CrossRefPubMedGoogle Scholar
- 32.Qiao JC, Chang ZG, Wei JM, Liu YN, Cui HY, Zhang Y (2013) Hepatic ectopic pregnancy treated successfully by hepatectomy. Chin Med J (Engl) 126(24):4806–4807Google Scholar