Diagnostic Challenges of an Abdominal Pregnancy in the Second Trimester

Abdominal pregnancies are a rare form of ectopic pregnancy, which presents a significant risk of maternal morbidity and mortality. We describe an unusual case of a late diagnosis of an abdominal pregnancy in the second trimester, which due to diagnostic challenges, was not detected on 1st trimester and subsequent antenatal ultrasound scans (USS). The abdominal pregnancy was later diagnosed at the repeat anomaly scan and confirmed with a pelvic MRI. This case of abdominal pregnancy is unique when compared to other reported cases, as the fetus was initially enclosed within the amniotic sac with normal liquor volume. Both transvaginal and transabdominal scans appeared to demonstrate an intrauterine pregnancy. The diagnosis of abdominal pregnancy was only made possible following rupture of the amniotic sac, leading to anhydramnios, which resulted in the repositioning of the fetus to the upper maternal abdomen. This case represents the challenges faced by obstetricians in diagnosing, managing, and counselling a woman when faced with an abdominal pregnancy.

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An unusual case of ruptured noncommunicating rudimentary horn pregnancy at 10 weeks

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20200389 ◽

2020 ◽

Vol 9 (2) ◽

pp. 839

Author(s):

Kiran Pande ◽

Angela Yadav

Keyword(s):

Maternal Morbidity ◽

Unusual Case ◽

Incomplete Fusion ◽

Second Trimester ◽

Catastrophic Event ◽

Rudimentary Horn ◽

Unicornuate Uterus ◽

Maternal Morbidity And Mortality ◽

Mullerian Ducts ◽

High Index Of Suspicion

Unicornuate uterus with noncommunicating rudimentary horn occurs due to incomplete fusion of mullerian ducts. Pregnancy in this horn is a rare phenomenon usually resulting in rupture during second trimester of pregnancy. Prerupture diagnosis of pregnancy in rudimentary horn with ultrasonography is technically difficult, with sensitivity of 30%. We report a case of ruptured non-communicating rudimentary horn at 10 weeks 3 days in a woman. She had a routine USG before pregnancy in which diagnosis was missed. Later she presented to emergency in shock, with massive hemoperitoneum and ruptured horn. So, a high index of suspicion is required to save this catastrophic event and associated maternal morbidity and mortality.

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Rare case of broad ligament pregnancy

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20212688 ◽

2021 ◽

Vol 10 (7) ◽

pp. 2893

Author(s):

Pragya Ojha ◽

Kalika Vaish

Keyword(s):

High Risk ◽

Early Diagnosis ◽

Maternal Morbidity ◽

Rare Case ◽

Broad Ligament ◽

Exploratory Laparotomy ◽

Abdominal Pregnancy ◽

Lower Abdomen ◽

Rare Form ◽

Maternal Morbidity And Mortality

Broad ligament pregnancy is rare form of abdominal pregnancy. There is high risk of maternal morbidity and mortality. Due to its rarity, usually, diagnosis cannot be established before surgery. We reported a 27 year old, G3P2L2 who presented with 4 month amenorrhea with pain in lower abdomen. Ultrasonography revealed a single live extra-uterine pregnancy of 17 weeks in right adnexa. A right sided Broad ligament pregnancy was found on exploratory laparotomy. Excision of mass with right sided salpingo-oophrectomy was performed. Post operative course was uneventful. Early diagnosis with high risk of suspicion and early intervention is needed to overcome it’s related complications.

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Heterotopic pregnancy: case report of a successful first trimester metacyesis management and a viable third trimester outcome

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20185448 ◽

2018 ◽

Vol 8 (1) ◽

pp. 332

Author(s):

Arvind Kumar Singh ◽

Shazia Khan

Keyword(s):

Case Report ◽

Maternal Morbidity ◽

Assisted Reproductive Technologies ◽

First Trimester ◽

Reproductive Technologies ◽

Heterotopic Pregnancy ◽

Third Trimester ◽

Intrauterine Pregnancy ◽

The Past ◽

Maternal Morbidity And Mortality

Heterotopic pregnancies are rare combined intra and extrauterine pregnancies, the incidence of which has shown an increase over the past decade with the rising trend in assisted reproductive technologies (0.75-1.5%). Authors report a case of a 29 year old primigravida, a post IVF conception who presented at 6 weeks POG with a ruptured tubal and a viable intrauterine pregnancy. She underwent an emergency laparoscopic right salpingectomy and continued with her intrauterine pregnancy successfully till term. The article emphasizes the need of scanning the adnexa carefully in early pregnancy to diagnose and manage heterotopic pregnancy as early as possible to prevent catastrophic haemorrhage and maternal morbidity and mortality later.

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Spontaneous heterotopic pregnancy with tubal rupture

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20175042 ◽

2017 ◽

Vol 6 (11) ◽

pp. 5148 ◽

Cited By ~ 1

Author(s):

Spandana J. C. ◽

Suresh S. Kanakannavar ◽

Umashankar K. M. ◽

Manuja N.

Keyword(s):

Maternal Morbidity ◽

Surgical Intervention ◽

Heterotopic Pregnancy ◽

Successful Outcome ◽

Intrauterine Pregnancy ◽

Pregnant Females ◽

Maternal Morbidity And Mortality ◽

Threatening Condition ◽

Life Threatening ◽

Ultrasound Assessment

Heterotopic pregnancy is the coexistence of intrauterine pregnancy (IUP) and extrauterine gestation. It is a rare and dangerous life-threatening condition that is difficult to diagnose and easily missed. The incidence in the general population is estimated to be 1 in 30,000. We report a case of a 24-year-old multigravida who was seen in the emergency department with a diagnosis of a ruptured ectopic pregnancy. A careful ultrasound assessment led to the diagnosis of a heterotopic pregnancy despite lack of any notable risk factors. Immediate surgical intervention with supportive measures resulted in a successful outcome. An obstetrician should keep in mind the occurrence of a heterotopic pregnancy while dealing with pregnant females. It also demonstrates that early diagnosis is essential in order to salvage the intrauterine pregnancy and avoid maternal morbidity and mortality.

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27 Weeks Abdominal Pregnancy wıth Mısdıagnosed at the Fırst Center, A Case Report

International Journal of Innovative Research in Medical Science ◽

10.23958/ijirms/vol04-i09/746 ◽

2019 ◽

Vol 4 (09) ◽

Author(s):

Recep ERİN ◽

Kadri TEZEL ◽

Ahmed ISAK ◽

Samira AHMED ◽

Mustafa KUŞAK

Keyword(s):

Abdominal Pregnancy ◽

Successful Management ◽

Intrauterine Pregnancy ◽

Incorrect Diagnosis ◽

Maternal Morbidity And Mortality ◽

Life Threatening ◽

Failed Induction ◽

Ectopic Pregnancies ◽

The Right ◽

High Index Of Suspicion

Abdominal pregnancy is a potentially life threatening form of ectopic gestation and is seen in 1% of all ectopic pregnancies. It’s a major cause of maternal morbidity and mortality and the potential mortality can be reduced seriously with early diagnosis and treatment. It is rarely seen in advanced pregnancy weeks due to detectability on ultrasonography in early weeks. We aimed to present a rare, misdiagnosed, abdominal pregnancy. We present a case of 20 years old primigravida with 27 weeks abdominal pregnancy who presented at the emergency room with abdominal pain and minimal vaginal bleeding. She was referred from another hospital after 2 days failed induction for incorrect diagnosis of intrauterine dead fetus. The ultrasonography was performed and seen a normal uterus with no intrauterine pregnancy but seen a single extra uterine fetus with 27 weeks gestational age lying in the peritoneal cavity on the right side. We managed successfully with laparotomy. Abdominal pregnancy is rare, and successful management depends on a high index of suspicion. Ultrasonography and serial human chorionic gonadotrophin may help in the diagnosis. Teamwork, a multidisciplinary approach and expert opinion cannot be overemphasised to ensure successful management of these cases.

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Case Report of Ruptured Non-Communicating Right Rudimentary Horn Pregnancy: An Acute Emergency

Acta Medica (Hradec Kralove Czech Republic) ◽

10.14712/18059694.2016.34 ◽

2011 ◽

Vol 54 (3) ◽

pp. 125-126 ◽

Cited By ~ 4

Author(s):

Che Hasnura Che Hassan ◽

Abdul Kadir Abdul Karim ◽

Nor Azlin Mohamed Ismail ◽

Mohd Hashim Omar

Keyword(s):

Case Report ◽

Acute Abdomen ◽

Vaginal Delivery ◽

Maternal Morbidity ◽

Hypovolemic Shock ◽

Provisional Diagnosis ◽

Intrauterine Pregnancy ◽

Rudimentary Horn ◽

Maternal Morbidity And Mortality ◽

Ruptured Uterus

Ruptured pregnancy in the rudimentary horn of women who have had a vaginal delivery is rare and unpredictable. However, when undiagnosed, this condition could lead to maternal morbidity and mortality. We report a pregnancy at 19 weeks gestation presented with acute abdomen and hypovolemic shock. She was initially thought to have an intrauterine pregnancy with the provisional diagnosis of a ruptured uterus. Intraoperatively, a ruptured non-communicating right rudimentary horn with ex utero pregnancy was discovered.

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Gestational diabetes mellitus and macrosomia: An analysis of secondary data

Journal of Health Technology Assessment in Midwifery ◽

10.31101/jhtam.819 ◽

2018 ◽

Vol 1 (2) ◽

pp. 94-98

Author(s):

Mufdlilah Mufdlilah ◽

Fijri Rachmawati

Keyword(s):

Diabetes Mellitus ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Maternal Morbidity ◽

Secondary Data ◽

Case Control ◽

Health Issues ◽

Control Approach ◽

The Past ◽

Maternal Morbidity And Mortality

Excessive fetal weight is considered as a health issues because it increases perinatal and maternal morbidity and mortality. The prevalence of macrosomia worldwide has increased over the past 2 to 3 decades. This study aimed to determine correlation between the incidence of gestational diabetes mellitus and macrosomia among pregnant women. The design of this study was analytical with a case control approach. Data used to analyze the incidence of macrosomia based on secondary data from 2014-2018. This research suggested that diabetes mellitus in pregnancy has a significant relationship with the incidence of macrosomia.

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