Ideally the management of<unk>  should be done by a team that has medical personnel from multiple specialties. Potential treatments consist of surgery with termination of the<unk>  (removal of the fetus) via laparoscopy or laparotomy, use of methotrexate, embolization, and combinations of these. Sapuri and Klufio indicate that conservative treatment is also possible if the following criteria are met: 1. there are no major congenital malformations; 2. the fetus is alive; 3. there is continuous hospitalization in a well-equipped and well-staffed maternity unit which has immediate blood transfusion facilities; 4. there is careful monitoring of maternal and fetal well being; and 5. placental implantation is in the lower abdomen away from the liver and spleen. The choice is largely dictated by the clinical situation. Generally, treatment is indicated when the diagnosis is made; however, the situation of the advanced<unk>  is more complicated. Advanced<unk>  Advanced<unk>  refers to situations where the<unk>  continues past 20 weeks of gestation (versus early<unk>  < 20 weeks). In those situations, live births have been reported in the lay press where the babies are not uncommonly referred to as 'Miracle babies'. A patient may carry a dead fetus but will not go into labor. Over time, the fetus calcifies and becomes a lithopedion. It is generally recommended to perform a laparotomy when the diagnosis of an<unk>  is made. However, if the baby is alive and medical support systems are in place, careful watching could be considered to bring the baby to viability. Women with an<unk>  will not go into labor. Delivery in a case of an advanced<unk>  will have to be via laparotomy. The survival of the baby is reduced and high perinatal mortality rates between 40–95% have been reported. Babies of<unk> es are prone to birth defects due to compression in the absence of the uterine wall and the often reduced amount of amniotic fluid surrounding the unborn baby. The rate of malformations and deformations is estimated to be about 21%; typical deformations are facial and cranial asymmetries and joint abnormalities and the most common malformations are limb defects and central nervous malformations. Once the baby has been delivered placental management becomes an issue. In normal deliveries the contraction of uterus provides a powerful mechanism to control blood loss, however, in an<unk>  the placenta is located over tissue that cannot contract and attempts of its removal may lead to life-threatening blood loss. Thus blood transfusion is frequent in the management of patients with this kind of<unk> , with others even using tranexamic acid and recombinant factor VIIa, which both minimize blood loss. Generally, unless the placenta can be easily tied off or removed, it may be preferable to leave it in place and allow for a natural regression. This process may take several months and can be monitored by clinical examination, checking human chorionic gonadotropin levels and by ultrasound scanning (in particular using doppler ultrasonography. Use of methotrexate to accelerate placental regression is controversial as the large amount of necrotic tissue is a potential site for infection, mifepristone has also be used to promote placental regression. Placental vessels have also been blocked by angiographic embolization. Complications of leaving the placenta can include residual bleeding, infection, bowel obstruction, pre-eclampsia (which may all necessitate further surgery) and failure to breast feed due to placental hormones. Outcome with<unk>  can be good for the baby and mother, Lampe described an<unk>  baby and her mother who were well more than 22 years after surgery.
Abdominal pregnancy
Cervical pregnancy
Cryptic pregnancy
Heterotopic pregnancy
Malignant triton tumor
Postterm pregnancy
Recurrent miscarriage
Ectopic pregnancy