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A pre-operatively diagnosed advanced abdominal pregnancy with a surviving neonate: a case report.

Gudu W, Bekele D - J Med Case Rep (2015)

Bottom Line: Her laboratory test results were unremarkable except for mild anemia.This is particularly important in areas where advanced imaging technologies are not readily available.Timely surgical intervention is imperative to avert maternal and fetal complications.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics & Gynecology, Karamara Regional Referral Hospital, P.O. Box 238, Jigjiga, Somali Regional State, Ethiopia. wondgu@yahoo.com.

ABSTRACT

Introduction: Abdominal pregnancy is a rare form of ectopic pregnancy with a high rate of maternal and fetal complications. Most of the reported cases are diagnosed in early trimesters, usually after presenting with complications. Advanced abdominal pregnancy poses a huge diagnostic and management challenge, particularly in low-income countries. A term abdominal pregnancy diagnosed pre-operatively and resulting in a surviving neonate is quite rare.

Case presentation: A 35-year-old, para 2, unbooked, Ethiopian Somali woman presented with amenorrhea of 9 months' duration, abdominal pain, and painful fetal movements of 4 months' duration. Her physical examination revealed a uterus sized 36 weeks' gestation with easily palpable fetal parts. Her laboratory test results were unremarkable except for mild anemia. Her ultrasound findings were suggestive of abdominal pregnancy. Laparotomy was done to salvage an alive healthy neonate from the peritoneum with removal of placenta implanted on the right broad ligament. The mother had a smooth post-operative course.

Conclusions: An advanced abdominal pregnancy diagnosed pre-operatively with delivery of a surviving neonate is rare. A high index of suspicion and thorough clinical and ultrasound evaluation are crucial to making an early diagnosis. This is particularly important in areas where advanced imaging technologies are not readily available. Timely surgical intervention is imperative to avert maternal and fetal complications.

No MeSH data available.


Related in: MedlinePlus

Ultrasound images of abdominal pregnancy. a The fetal spine (lower arrow) can be seen just under abdominal wall echo (upper arrow) without intervening myometrial tissue. b An empty uterus
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Fig1: Ultrasound images of abdominal pregnancy. a The fetal spine (lower arrow) can be seen just under abdominal wall echo (upper arrow) without intervening myometrial tissue. b An empty uterus

Mentions: The laboratory findings were all unremarkable, except for mild anemia (hemoglobin of 10g/dl). Ultrasound scanning revealed an enlarged, otherwise empty uterus with a thick endometrial echo and a 37 weeks’ gestation singleton, viable pregnancy in transverse lie with no intervening myometrial tissue (echo) between fetal parts and the abdominal wall (Fig. 1). There was an ill-defined, echo-complex mass in the right adnexa measuring 12cm×10cm with high Doppler flow. No amniotic fluid pool could be seen, but there was a small amount of free peritoneal fluid in the left paracolic gutter. The sonographic diagnosis was viable third-trimester abdominal pregnancy.Fig. 1


A pre-operatively diagnosed advanced abdominal pregnancy with a surviving neonate: a case report.

Gudu W, Bekele D - J Med Case Rep (2015)

Ultrasound images of abdominal pregnancy. a The fetal spine (lower arrow) can be seen just under abdominal wall echo (upper arrow) without intervening myometrial tissue. b An empty uterus
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4597396&req=5

Fig1: Ultrasound images of abdominal pregnancy. a The fetal spine (lower arrow) can be seen just under abdominal wall echo (upper arrow) without intervening myometrial tissue. b An empty uterus
Mentions: The laboratory findings were all unremarkable, except for mild anemia (hemoglobin of 10g/dl). Ultrasound scanning revealed an enlarged, otherwise empty uterus with a thick endometrial echo and a 37 weeks’ gestation singleton, viable pregnancy in transverse lie with no intervening myometrial tissue (echo) between fetal parts and the abdominal wall (Fig. 1). There was an ill-defined, echo-complex mass in the right adnexa measuring 12cm×10cm with high Doppler flow. No amniotic fluid pool could be seen, but there was a small amount of free peritoneal fluid in the left paracolic gutter. The sonographic diagnosis was viable third-trimester abdominal pregnancy.Fig. 1

Bottom Line: Her laboratory test results were unremarkable except for mild anemia.This is particularly important in areas where advanced imaging technologies are not readily available.Timely surgical intervention is imperative to avert maternal and fetal complications.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics & Gynecology, Karamara Regional Referral Hospital, P.O. Box 238, Jigjiga, Somali Regional State, Ethiopia. wondgu@yahoo.com.

ABSTRACT

Introduction: Abdominal pregnancy is a rare form of ectopic pregnancy with a high rate of maternal and fetal complications. Most of the reported cases are diagnosed in early trimesters, usually after presenting with complications. Advanced abdominal pregnancy poses a huge diagnostic and management challenge, particularly in low-income countries. A term abdominal pregnancy diagnosed pre-operatively and resulting in a surviving neonate is quite rare.

Case presentation: A 35-year-old, para 2, unbooked, Ethiopian Somali woman presented with amenorrhea of 9 months' duration, abdominal pain, and painful fetal movements of 4 months' duration. Her physical examination revealed a uterus sized 36 weeks' gestation with easily palpable fetal parts. Her laboratory test results were unremarkable except for mild anemia. Her ultrasound findings were suggestive of abdominal pregnancy. Laparotomy was done to salvage an alive healthy neonate from the peritoneum with removal of placenta implanted on the right broad ligament. The mother had a smooth post-operative course.

Conclusions: An advanced abdominal pregnancy diagnosed pre-operatively with delivery of a surviving neonate is rare. A high index of suspicion and thorough clinical and ultrasound evaluation are crucial to making an early diagnosis. This is particularly important in areas where advanced imaging technologies are not readily available. Timely surgical intervention is imperative to avert maternal and fetal complications.

No MeSH data available.


Related in: MedlinePlus