Published Paper Details:

An extremely uncommon and severe type of abdominal ectopic pregnancy is called hepatic pregnancy, in which the embryo implants and grows on the liver's surface or inside its parenchyma. With fewer than 100 cases documented in the literature globally, hepatic pregnancies make up a very small percentage of all abdominal pregnancies and represent one of the rarest implantation sites in ectopic gestation. Due to the condition's uncommon clinical appearance and rarity, early identification is extremely challenging, frequently leading to delayed recognition and treatment, which can have potentially fatal outcomes for the mother. Nonspecific symptoms such right upper quadrant stomach pain, shoulder tip pain, gastrointestinal discomfort, nausea, or indications of internal bleeding--especially in situations of rupture--may be present in patients with hepatic pregnancy. These symptoms are frequently deceptive and do not immediately trigger suspicion of ectopic gestation, in contrast to tubal ectopic pregnancies. Furthermore, because of the liver's abundant arterial supply, hepatic pregnancies may progress farther into gestation than other ectopic kinds, raising the possibility of catastrophic hemorrhage. Imaging modalities have a major role in diagnosis. Hepatic implantation sites are frequently overlooked because of their location, even though transvaginal ultrasonography is still the first-line method for assessing suspected ectopic pregnancies. Doppler tests, abdominal ultrasonography, and particularly computed tomography (CT) and magnetic resonance imaging (MRI) scans are essential for pinpointing the precise location of implantation and assessing the degree of placental invasion into hepatic tissue. Hepatic pregnancy management is quite complicated and unique to each patient. Frequently, surgery is required, which may involve a laparotomy in which the gestational tissue is removed. Hepatic resection, hepatic vascular ligation, or preoperative embolization may be necessary in some circumstances to stop bleeding. In certain situations, either as a supplement to surgery or in situations where surgery has significant dangers, the chemotherapeutic drug methotrexate has been used to cause trophoblastic regression. However, a multidisciplinary team of obstetricians, general surgeons, hepatobiliary specialists, and interventional radiologists must carefully arrange treatment techniques. Hepatic pregnancy still carries a high risk of maternal morbidity and death, even with improvements in surgical and diagnostic imaging methods. Improving results requires prompt diagnosis, careful preoperative planning, and all-encompassing supportive care.