Abdominal pregnancy with a healthy newborn: a new case

Abstract

Abdominal pregnancy is a rare form of ectopic pregnancy with very high morbidity and mortality for both the mother and the fetus. Diagnosis and management can pose some difficulties especially in low-resource centers. We report a case of abdominal pregnancy with a healthy newborn. A 34-year-old Moroccan woman, G4P3 (3 alive children), presented with shortness of breath and progressive abdominal distension and pain at 37 weeks' gestation. An emergency laparotomy was performed with the impression of abdominal pregnancy. Intraoperatively, the fetus was seen in an intact amniotic sac in her abdomen, the placenta was strongly adhered to the fundus and enveloped the left adnexa. A total hysterectomy with a left adnexectomy was performed. The patient and neonate progressed well and were discharged. Term abdominal pregnancy is an extremely rare diagnosis. The life-threatening complication is bleeding from the detached placental site. High index of suspicion is vital in making prompt diagnosis in such situations.

Advanced Abdominal Ectopic Pregnancy with Subsequent Fetal and Placental Extraction: A Case Report

“…Clinical evaluation is important to diagnose an abdominal pregnancy, unlike tubal EPs which may go undetected until late gestational age [9]. This is due to a clinical picture that varies from asymptomatic patients to others with severe symptoms that can compromise both maternal and fetal life [3].…”

“…AEP is usually diagnosed late because some patients are asymptomatic, or if symptomatic, the symptoms are nonspecific [8]. It may present as diffuse pain accompanied by signs of incipient pregnancy [9].…”

Undiagnosed advanced abdominal pregnancy: a case report

“…Management depends on when the diagnosis is made, because is a life-threatening condition, pregnancy is usually terminated as soon as the diagnosis of abdominal pregnancy is made by laparotomy for better heamostasis, although laparoscopic approach has been lauded recently. 1,6,7,9 A cautious expectant management may be carried out in selected cases, if it is diagnosed late, that is >24 weeks, with careful monitoring of maternal and fetal condition in a well-equipped setting for blood transfusion facility and emergency laparotomy. 8 Expectant management, however, carries a risk of sudden lifethreatening intra-abdominal bleeding and a generally poor fetal prognosis.…”

“…It accounts for about 1:10,000 to 1:30,000 (about 1%) of all ectopic pregnancies. 1,2 The sites of implantation include the omentum, pelvic side wall, the Douglas pouch, spleen, bowel, liver, large pelvic vessels, diaphragm, and uterine serosa. 3 The incidence is higher in women of low-and middleincome countries and this can be attributed to low socioeconomic status, high rate of pelvic inflammatory disease or pelvic infection, history of infertility, tubal sterilization, tubal reconstruction surgery and pregnancy with intra uterine device.…”

Abdominal pregnancy with a live newborn in a low-resource setting: A case report

“…Secondary abdominal pregnancy occurs after tubal rupture or abortion or uterine rupture with secondary peritoneal implantation [ 2 ]. It is a rare form of ectopic pregnancy with high morbidity and mortality for both the mother and the fetus [ 3 ]. Abdominal pregnancy represents 1–1.5% of all ectopic pregnancies, with an estimated incidence of 1:8000–10,000 pregnancies [ 1 ].…”