Combined surgical and medical management of a broad ligament
• Broad ligament ectopic pregnancies are rare and often diagnosed intraoperatively.

• Several case reports document successful treatment of these pregnancies with surgery.

• Prophylactic methotrexate can be considered if there is a concern for retained trophoblastic tissue.

Broad ligament ectopic pregnancies are rare. Several case reports illustrate treatment with laparoscopy. A 31-year-old woman, gravida 2 para 1, presented at 6 weeks 6 days of gestation with vaginal bleeding. She had a ?-hCG level of 7424 IU/L and ultrasound showed a 1.8 cm ectopic pregnancy with fetal cardiac activity in the left adnexa. Diagnostic laparoscopy revealed a left broad ligament ectopic pregnancy. The products of conception were removed surgically, and she received prophylactic two-dose methotrexate. Her ?-hCG returned to non-pregnant levels within one month. This is the first case report to describe laparoscopy with postoperative prophylactic methotrexate for successful treatment of a broad ligament pregnancy. This treatment protocol with methotrexate can be considered in future cases.