Advanced abdominal pregnancy, with live fetus and severe preeclampsia, case report

Abstract

BackgroundAbdominal pregnancy may account for up to 1.4% of all ectopic pregnancies. The incidence of abdominal pregnancy differs in various literatures and ranges between 1:10,000 pregnancies to 1:30, 000 pregnancies. The clinical symptoms of an uncomplicated abdominal pregnancy are unspecific. There are reports of maternal and fetal survival from advanced abdominal pregnancies.Case presentationOur case was a 26 years old gravida 4, para 3 (2 alive, one early neonatal death) woman. She presented to Felegehiwot Referal Hospital with a principal complaint of vomiting, epigastric pain, headache, and blurring of vision. Emergency cesarean delivery was decided with the impression of bicornuate uterus with intrauterine pregnancy, intrauterine growth restriction and sever preeclampsia.it was found to be advanced abdominal pregnancy. Placenta was removed and pack was used to control bleeding. Both the mother and neonate were discharged in a good condition.ConclusionAbdominal pregnancy with live fetus is an extremely rare condition and requires a high index of suspicion. Endometrial cavity may not be required for development of severe preeclampsia and packing is effective in controlling bleeding in selected cases.

Late abdominal pregnancy in a post-conflict context: case of a mistaken acute abdomen - a case report

“…Abdominal pregnancy is categorized as either 'early' (≤ 20-weeks gestation) or 'late' (> 20-weeks gestation) depending on the gestational age at which the diagnosis is made. Abdominal pregnancy is often fatal to both the fetus and the mother [1,9] and careful management is required in order to save their lives [10]. Although proper diagnosis is needed to improve outcomes, unfortunately the diagnosis of abdominal pregnancy is often missed in routine antenatal care [7].…”

“…Making the diagnosis of abdominal pregnancy is challenging. While in more developed settings, magnetic resonance imaging (MRI) is the diagnostic method of choice for abdominal pregnancy, particularly in the more advanced stages [2,14], in low-and middle-income countries, clinicians must rely on good clinical judgement, and where available, on ultrasound [1,10]. When performed in the first trimester, ultrasound will show an empty uterus with a separate gestational sac, or with a mass separated from the uterus, adnexa, and ovaries.…”

“…Abdominal implantation of a pregnancy is uncommon, accounting for 1.4% of all ectopic pregnancies and with a reported range of 1:10000 to 1:30000 pregnancies [1][2][3]. Abdominal pregnancies have been reported in several contexts in both high-income countries as well as lowand middle-income countries.…”

Expectant Management of an Abdominal Pregnancy Diagnosed at 18 Weeks: A Case Report

“…The partial and complete removal of the placenta have been reported with successful outcome [30,31], however, if removal of the placenta is not possible due massive vascular invasion, it is recommended to leave the placenta in situ and maintain a close follow-up for involution and early identification of potential complications. Thus, placental management must be individualized and assessed at the operating room, removing it only if it is safe to do [32][33][34]. Use of postoperative methotrexate has been described in cases with placenta left in situ, although some authors have proposed that rapid placental destruction leads to accumulation of necrotic debris, favoring bacterial growth [20].…”

Abdominal pregnancy during the COVID‐19 pandemic

“…Abdominal pregnancy is a rare type of ectopic pregnancy with an incidence of 1:10 000 to 1:30 000 women 1 . Several different locations have been reported, including the pouch of Douglas, pelvic sidewall, bowel, broad ligament, omentum, and spleen 2,3 . Most abdominal pregnancies are diagnosed after presenting with various complications; however, in a few cases it may remain asymptomatic and is rarely established before surgery 4 .…”