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An abdominal pregnancy after treatment with human menopausal and chorionic gonadotropins is reported. The role of induction of ovulation with human menopausal and chorionic gonadotropins as a cause of ectopic pregnancy has not been delineated. However, it appears that ultrasonography has become one of the most important aids in the diagnosis of abdominal pregnancy.
Abdominal pregnancy is a rare condition representing 1-2% of all pregnancies; early diagnosis is difficult, but the challenge is the advanced pregnancy with adequate clinical condition for conservative management. There are few cases in which conservative management can improve, even though when the abdominal pregnancy is secondary to ruptured interstitial localization. A case of secondary (interstitial) abdominal pregnancy with conservative management and post-operative eventful for the mother and fetus is discussed.
BACKGROUND: Abdominal pregnancy is a rare obstetric emergency, occurring in 1 in 10,000 pregnancies. CASE: An 18-year-old woman, gravida 3, para 1, presented for evaluation of an abnormal level of maternal serum alpha-fetoprotein. Transabdominal ultrasound examination revealed absence of amniotic fluid with limited imaging ability. Transabdominal amnioinfusion was done to better visualize the fetus. A small uterus was seen in the pelvis, and an abdominal pregnancy was identified with the placenta attached anteriorly over the right pelvic sidewalls. After delivery of the fetus, the placenta was left in situ. The patient recovered postoperatively and was doing well a year after the procedure. A 12 x 10-cm mass remains over the right pelvic sidewall without detectable Doppler blood flow. CONCLUSION: State-of-the-art imaging and prenatal diagnostic techniques allowed correct diagnosis, adequate preparation and optimal management of this dangerous condition.
A case report is described in which abdominal pregnancy was misdiagnosed by ultrasound scanning as a pregnancy within a horn of a bicornuate uterus. Two serum alpha fetoprotein (SAFP) results were greatly elevated and an amniocentesis was performed, the liquor alpha fetoprotein (LAFP) and karyotype were normal. Elective Caesarean section was performed at 38 weeks for a persistent transverse lie and an abdominal pregnancy was found. The outcome was excellent for both the mother and child. This is the first reported case of amniocentesis and measurement of LAFP in an abdominal pregnancy and confirms abdominal pregnancy as a rare cause of an elevated SAFP.
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Extrauterine pregnancies scarcely achieve an advanced developmental stage and were rarely diagnosed preoperatively. Even the ultrasonic B scanning don't eliminate the difficulties in recognising the ectopic pregnancy. We can demonstrate this by means of 3 case. In one of them, a case of full term abdominal pregnancy with healthy fetus, we could diagnose this preoperatively.
Abdominal pregnancy is a rare but life-threatening condition. The preoperative diagnosis may be difficult. When there is a suspicion of abdominal pregnancy and ultrasonographic findings are equivocal or inconclusive, MR imaging should be performed. We report a case of an abdominal pregnancy of 28 weeks' gestation diagnosed by MR.
A case is described of abdominal pregnancy in a 27-year-old patient with a previous salpingectomy of the right tube performed because of tubal pregnancy. The patient was hospitalized in the 22nd to the 28th week of pregnancy on suspicion of imminent abortion. Clinical and ultrasound examinations indicated intrauterine pregnancy, by just before the expected date of delivery, clinical symptoms suggested abdominal pregnancy. The oxytocin test was negative. Following laparotomy a live normal girl was born, weighting 3200 g. The placenta was inserted at the front wall and the right horn of the uterus from the outer side. In the right horn there was an opening at the site of the oviduct excision. Because of profuse bleeding, the uterus was amputated supravaginally.
The abdominal pregnancy is a rare, but life threatening complication of ectopic embryo implantation. Only three cases of abdominal pregnancy have been previously described in primates: in a squirrel monkey, owl monkey and in a rhesus macaque. A 14-year-old wild-caught olive baboon (Papio cynocephalus anubis) was diagnosed at the ultrasound examination with advanced gestational age extrauterine pregnancy. At the initial laparotomy and necropsy the diagnosis of abdominal pregnancy was made on Studdiford's criteria. This case indicates the possibility of developing a model for further study of different types of ectopic pregnancy and indicates a cesarean section as a risk factor for abdominal pregnancy.
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A case is presented of a spontaneously conceived heterotopic pregnancy in a 38-year-old Haemoglobin SS woman, with intrauterine foetal demise and survival of the extra-uterine pregnancy, which was an abdominal pregnancy. The diagnosis was not made until delivery. This report should create the awareness of the possibility of abdominal or heterotopic pregnancy in spontaneous cycles, particularly in patients with recurrent severe anaemia in pregnancy, whether or not they have haemoglobinopathies.
A case of advanced abdominal pregnancy was diagnosed at laparotomy. During surgery, there was massive haemorrhage from the placenta which was controlled using surgical gauze packing.
A rare case of abdominal pregnancy, causing massive rectal bleeding due to invasion of the rectal wall by the placenta, is reported.
An advanced case of abdominal pregnancy of 31.5 weeks of evolution, is presented. Etiology aspects, frequency, clinical aspects, complications, diagnostics and treatment, are commented upon. The case was resolved by an exploratory laparotomy. A single alive product, female of 1.775 Kg. Apgar of 6,8,9, was obtained. Neither trans or post operative complications of consideration, were present. There were no mother or fetal mortality.