CPT® Code 59130

1. Indications

The surgical treatment of an abdominal ectopic pregnancy is indicated in specific clinical scenarios where the pregnancy is not viable and poses a risk to the patient's health. The following conditions warrant this procedure:

• Abdominal Ectopic Pregnancy The presence of a fertilized ovum implanted in the abdominal cavity, which can lead to complications such as hemorrhage or organ damage.
• Gestational Age Considerations The procedure may be indicated based on the gestational age of the pregnancy, as earlier interventions can reduce the risk of complications.
• Placental Attachment If the placenta is attached to other structures such as the fallopian tube or ovary, surgical intervention is necessary to prevent further complications.

2. Procedure

The surgical procedure for treating an abdominal ectopic pregnancy involves several critical steps to ensure the safe removal of the ectopic tissue and to minimize risks to the patient. The following procedural steps are performed:

• Step 1: Incision An incision is made in the abdomen to provide access to the abdominal cavity. The location and size of the incision may vary depending on the specific circumstances of the pregnancy and the surgeon's preference.
• Step 2: Exposure of the Ectopic Site Once the incision is made, the surgical team carefully exposes the site of the abdominal pregnancy. This step is crucial for visualizing the ectopic tissue and assessing its relationship to surrounding structures.
• Step 3: Interruption of Blood Supply The next step involves interrupting the placental blood supply. This is achieved by ligating the umbilical cord and any associated blood vessels, which is essential to prevent excessive bleeding during the removal process.
• Step 4: Removal of Embryo and Membranes The embryo or fetus, along with the surrounding membranes, is then surgically removed from the abdominal cavity. This step requires careful handling to avoid damaging surrounding organs.
• Step 5: Removal of Placenta If the placenta is found to be attached to any extrauterine structures, such as the fallopian tube or ovary, it is also excised to ensure complete removal of all ectopic tissue.
• Step 6: Irrigation and Clot Removal After the removal of the ectopic tissue, the abdomen is irrigated to clear any blood clots and ensure a clean surgical field.
• Step 7: Closure of the Abdomen Finally, the abdomen is closed in layers, which is important for proper healing and to minimize the risk of infection.

3. Post-Procedure

Post-procedure care following the surgical treatment of an abdominal ectopic pregnancy is essential for the patient's recovery. Patients are typically monitored for any signs of complications, such as excessive bleeding or infection. Pain management is provided as needed, and patients may be advised to limit physical activity during the initial recovery period. Follow-up appointments are crucial to ensure proper healing and to address any concerns that may arise after the surgery. Additionally, patients may receive counseling regarding future pregnancies and the implications of having had an ectopic pregnancy.