Abdominal Pregnancy
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2021 ◽  
Vol 2021 ◽  
pp. 1-6
Tatsuji Hoshino ◽  
Tatsuo Mori ◽  
Yu Fujii ◽  
Shinya Yoshioka

Background. An advanced abdominal pregnancy (AAP) rarely continues to a live birth, but sometimes, a live birth may occur. In developed countries, women with AAP who have not been diagnosed preoperatively are expected to be diagnosed quickly, and the pregnant woman and the fetus will be saved. After careful examination of the past cases, we sought to derive what is the best diagnosis and treatment choice in the current medical environment. Materials and Methods. We retrospectively studied AAP cases in Japan. We examined diagnosis of AAP before fetal delivery and placental treatment at the time of delivery. AAP was well documented in 10 cases. We contacted the AAP authors, who reported 10 AAP cases in Japan, directly to confirm any unclear points. Results. Two cases were diagnosed with AAP before laparotomy, one was diagnosed after IUFD, and seven were diagnosed at the time of laparotomy. The two most recent cases were diagnosed with AAP preoperatively by ultrasound and MRI. Six cases were described for preoperative diagnosis. There were two cases of placenta previa, one of a bicornuate uterus, one of breech presentation, one of a combination of uterine cervical fibroids and placenta previa, and one of a combination of presentation and placental abnormality with uterine fibroids. In five cases, the placenta was removed at the time of laparotomy. Simultaneous removal of the placenta during laparotomy could not be performed because of intra-amniotic infection with a macerated fetus in an IUFD case. Among eight cases, excluding 20-week and 21-week gestation with no expectation of viable newborns, there were one male and seven female fetuses. The birth weight ranged from 1765 to 3520 g, with a median birth weight of 2241 g. Combined malformations were described in six of the seven live births. Clubfoot, torticollis, joint contracture, and bone deformity were transient because intrauterine compression quickly improved. Conclusion. In recent cases, AAP has been diagnosed by MRI and ultrasound. MRI should be performed if abdominal pregnancy is suspected. Postoperative infections may occur if the placenta is not removed at the time of delivery. We recommend placental resection with the help of an anesthesiologist, a gynecologist, a urologist, and a surgeon in the current medical environment.

2021 ◽  
Vol 5 (2) ◽  

The pseudo-unicornuate uterus which is a rare uterine malformation, that can be the site of a pregnancy. Pregnancies in the rudimentary horn usually result in a rupture due to a uterine wall not adapted to the level of the horn, but especially diagnostic difficulties. Their discovery is most often made in intraoperative, when an indication of laparotomy is made for hemoperitoneum in emergency. They are therefore responsible for high maternal-fetal mortality and morbidity. We report in this observation a case of pregnancy in a rudimentary unruptured horn, in a 28-year-old, 4th gesture 2nd parous, the discovery of which was made incidentally, during an indication of laparotomy posed for suspected abdominal pregnancy complicated by a surgical abdomen.

Pragya Ojha ◽  
Kalika Vaish

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.

2021 ◽  
Vol 5_2021 ◽  
pp. 180-184
Ivanova N.A. Ivanova ◽  
Kormakova T.L. Kormakova ◽  
Ukvalberg M.E. Ukvalberg ◽  
Lazareva A.A. Lazareva A ◽  
Shvedkina N.N. Shvedkina ◽  

F.E.L. MISKI ◽  

2021 ◽  
Vol 15 (1) ◽  
Abraham Fessehaye ◽  
Biruck Gashawbeza ◽  
Mekdes Daba ◽  
Muhudin Arusi ◽  
Tsega Terefe

Abstract Background Abdominal pregnancy accounts for 0.6 to 4% of all ectopic pregnancies. Due to delays in diagnosis and difficulties in the management of abdominal pregnancy, the risk of mortality is significantly higher than for uncomplicated ectopic pregnancies. Case summary A 23 years-old gravida-II, ectopic-I Ethiopian woman was initially managed as a case of missed second trimester abortion. Later on, abdominal ectopic pregnancy was diagnosed with ultrasound and she underwent a laparotomy. Though fetus and placenta was removed successfully without significant hemorrhage, there was inadvertent sigmoid colon injury. Conclusion In the management of abdominal ectopic pregnancy, the possibility of bowel injury during entry to the abdominal cavity at laparotomy should always be considered and an experienced general surgeon should always be in attendance before opening the abdomen, to prevent it from happening.

Zainul Ikhwan Ahmad Khusairi ◽  
Tan Ling Sze

Introduction: Most pregnant women will experience a normal pregnancy process. However, there are some complications that may occur during pregnancy, including intra-abdominal pregnancy. Intra-abdominal pregnancy, or pregnancy outside of the uterus, are commonly reported besides abortion, pregnancy-induced hypertension (PIH) and gestational diabetes mellitus (GDM). Thesecomplications are believed to be the main cause of maternal and perinatal death. Therefore, the use of appropriate diagnostic imaging inthe management of obstetric cases should be focused.Objective: This case study intended to evaluate the use of magnetic resonance imaging (MRI) in managing intra-abdominal pregnancy.Case Presentation: The study focused on one case with intra-abdominal pregnancy which continued into the second trimester. A 30-year-old woman, G2 P0+1 at 12-13 weeks’ gestation was presented to a public hospital complaining of recurrent epigastric pain with no history of vaginal bleeding. An MRI was performed and the mother was identified as having an intraabdominal pregnancy. Urgent laparotomy was done. Intraoperative finding noted hematoperitoneum with active bleeding seen from the placenta that adhered to the omentum. Partial omentectomy was done. The foetus in about 14 week’s gestation was seen and removed. Case studies have proven that the option to perform an MRI on a suspected intra-abdominal pregnancy can help provide information to establish an accurate diagnosis and appropriate patient care management.Conclusion: The use of MRI is highly recommended for all cases that are expected to experience intra-abdominal pregnancy as it will save the patient as well as avoiding obstetric complications.International Journal of Human and Health Sciences Supplementary Issue: 2021 Page: S16

Widiastuti Soewondo ◽  
Sulistyani Kusumaningrum ◽  
Prasetyo Sarwono Putro ◽  
Ifada Indriyani ◽  
Ida Prista Maryetty ◽  

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