Full-term abdominal pregnancy case

The article gives account of the case offull-term abdominal pregnancy with comparatively favourable course that led to diagnostic mistakes and complications, but resulted in the birth of healthy child without any signs of asphyxia.

Ruptured Hemorrhagic Ectopic Pregnancy Implanted in the Diaphragm: A Rare Case Report and Brief Literature Review

The mortality and morbidity rates of non-tubal ectopic pregnancies with abdominal hemorrhaging are 7–8 times higher than those of tubal pregnancies. Diaphragmatic pregnancy is a rare non-tubal ectopic form, causing acute abdominal hemoperitoneum. Here, we present a case of a primary diaphragmatic ectopic pregnancy with hemorrhage that was immediately diagnosed and successfully managed with laparoscopic surgery. Rapid and accurate diagnosis using appropriate imaging modalities is critical for improving the prognosis of a child-bearing woman with an abdominal pregnancy.

Undiagnosed advanced abdominal pregnancy: a case report

<p class="abstract">Abdominal pregnancy is a rare form of extra-uterine gestation in which implantation occurs in the peritoneal cavity, unlike this case it rarely reaches advanced gestation and viability of fetal outcome are not commonly documented. Abdominal pregnancy accounts for about 1-2% of ectopic gestation. It is associated with poor fetal outcome and great morbidity and mortality due to heamorrhage especially in a low resource setting. We present an undiagnosed advanced case of abdominal pregnancy of a 30 yr old unbooked G2P1+0 (1A) with early ultrasound estimation of 37 weeks and 6 days. She presented with (abdominal) labour pains and ultrasound diagnosis of breech presentation, suspicion of a bicornuate uterus and intrauterine growth restriction. She was planned for emergency cesarean delivery on this basis but found advanced abdominal pregnancy, and subsequently on delivery had good maternal and fetal outcome. Abdominal pregnancy with live fetus is extremely rare, and requires a high index of suspicion, to avoid high risk of maternal morbidity and mortality and it is also imperative for all healthcare givers to localized pregnancy whenever they get in contact with a woman who has recently missed her period.</p>

Second trimester Abdominal Pregnancy: A Case Report in a Resource Limited Setting

Introduction: Abdominal pregnancy is a rare form of ectopic pregnancy with very high feto-maternal morbidity and mortality. Diagnosis and management can pose difficulties in low-resource centres. High index of suspicion is vital in making a prompt diagnosis. Case Presentation: A 23year old, gravida 2, para 1, who presented with a two-day history of severe abdominal pain was referred from a satellite clinic. Abdominal ultrasound scan revealed a live 18week 5day intra-abdominal pregnancy. Emergency laparotomy showed an intact gestational sac at the superior aspect of the uterus with massive hemoperitoneum. The placenta was attached to the right ovary, omentum, and fimbriae of the right fallopian tube. Conclusion: Abdominal pregnancy is a rare occurrence and requires a high index of suspicion for prompt diagnosis. Massive hemoperitoneum can be life threatening and prompt surgical intervention is key in saving the life of the mother.

Foley catheter tourniquet for uncontrollable extra-uterine placental hemorrhage: description of a novel surgical technique.

Introduction Hemorrhage from a partially or fully detached placenta with an advanced abdominal pregnancy can be profuse and catastrophic. The general approach to placenta management is removal of “all or nothing’’. In the event of acute hemorrhage, every attempt to achieve hemostasis quickly is critical. The Foley catheter has shown utility when used to control placental hemorrhage or as a temporary tourniquet applied around structures surrounding the implantation site to aid placental removal with minimal hemorrhage. We report use of the technique on four occasions with good surgical outcomes. Case Presentation We report a case of a 33 year-old primigravida admitted at term with an ultrasound diagnosis of breech presentation and placenta previa grade four. Her pre-operative clinical assessment however, raised suspicion of an abdominal pregnancy. At laparotomy, a live female infant was delivered from the extra-uterine gestation sac, weighing 3640g and with an Apgar score of 7 and 6 at one and 5 minutes respectively. Following delivery, there was profuse bleeding from the partially detached distal portion of the placenta that derived rich blood supply from the poorly accessible posterior pelvic wall. We applied a novel, simple and effective surgical technique for minimizing blood loss from the partially detached placenta using a Foley’s catheter tourniquet that was applied between the detached and still attached parts of the placenta. The tourniquet was left in situ and removed at laparotomy 4 days later. The placenta was not removed. The mother and baby did well postoperatively and were discharged after 10 and 21 days respectively in good condition. The surgical technique was similarly used in 3 additional cases with good clinical outcomes. Discussion Use of a Foley catheter as an intraoperative tourniquet has become accepted as a useful technique in obstetric and gynecological surgery. We describe a simple life saving technique of applying a Foley tourniquet across a partially detached placenta following an advanced extra-uterine pregnancy to control acute hemorrhage. Conclusion We recommend that surgeons keep in mind the option of intraoperative tourniquets when faced with uncontrollable bleeding as a short-term or medium-term temporizing measure.