Transfemoral temporary aortic balloon occlusion in surgical treatment of second trimester intramural ectopic pregnancy

Intramural ectopic pregnancy is a rare type of ectopic pregnancy that may lead to life-threatening hemorrhage. In the present case, a 20-year-old woman at 18.5 weeks of gestation, G1P0, was diagnosed with intramural ectopic pregnancy on ultrasound and magnetic resonance imaging, which showed a 14-cm × 14-cm gestational sac on the right posterior lateral side of the uterus fundus, surrounded completely by myometrium. Considering the increased risk of bleeding during surgery, transfemoral temporary aortic balloon occlusion was performed during laparotomy. The intramural ectopic gestational sac was successfully resected without life-threatening obstetric hemorrhage. This procedure could offer an alternative approach to classic uterine artery embolization in reducing intraoperative bleeding thus avoiding blood transfusion. Aortic balloon occlusion is the temporary occlusion of the aorta, therefore it does not influence future fertility. In conclusion, transfemoral temporary aortic balloon occlusion is an effective procedure in the surgical treatment of intramural ectopic pregnancy diagnosed beyond the first trimester.