Fate of hepatic ectopic pregnancy 1-year post-treatment: still visible

Abdominal pregnancies, 1% of all ectopic pregnancies, present diagnostic complexities with a significant risk of intraperitoneal haemorrhage and mortality. Hepatic occurrences are exceptionally uncommon, with treatment strategies less established.A woman in her early 30s and third pregnancy underwent laparotomy due to haemoperitoneum suspecting an ectopic pregnancy, but normal pelvic structures were observed. Ultrasound and MRI confirmed the hepatic location of a gestational sac of 4 cm with a live fetus at 9 weeks. Intragestational sac methotrexate was administered under ultrasound guidance along with a single intramuscular dose due to high serum β-hCG which became undetectable after 8 weeks. The patient experienced no significant complications and was followed up for a year where an avascular gestational sac of 13 mm was still imaged.Hepatic pregnancy represents an exceptionally rare subset of abdominal pregnancies, frequently challenging to diagnose due to its atypical location. This is a first-of-its-kind report of imaging follow-up until 1 year.