PMC7178462_01
(a) The anatomical relation with other pelvic structures is shown in this panel. (b) Profuse bleeding caused by spontaneous rupture of the ectopic. (c) The superior branches of the right uterine artery were coagulated and transected. (d) Injection of diluted vasopressin in the myometrium, close to the border of the ectopic. (e) The uterine wall is incised with monopolar cautery. (f) The gestational sac is exposed and ruptured during dissection. (g) A portion of the uterine horn has been excised. (h) The uterine wound was closed with interrupted sutures.
CRIOG2020-5626783.001.jpg
PMC7178462_01_CRIOG2020-5626783.001.jpg
fig1
The diameter of the ectopic pregnancy exceeded the diameter of the uterus (Figure 1(a)). During incision of the round ligament, spontaneous rupture of the ectopic sac occurred, resulted in profuse bleeding (Figure 1(b)). The superior branches of the right uterine artery were then coagulated and transected. (Figure 1(c)) Bleeding was thus reasonably controlled. Diluted vasopressin was injected (1 mL of 20 U of vasopressin diluted with 40 mL of normal saline) in the myometrium close to the border of the ectopic (Figure 1(d)). The uterine wall was then incised with monopolar current, set at 30 W (Figure 1(e)). During dissection, the gestational sac was exposed and ruptured (Figure 1(f)). The whole of the ectopic was removed with a portion of the uterine horn (Figure 1(g)). Interrupted inverted sutures (Monocryl No. 1) were placed at the uterine wound (Figure 1(h)).