Abdominal pregnancy secondary to iatrogenic uterine perforation: A case report and literature review

Abdominal pregnancy is a rare and life-threatening form of ectopic pregnancy.It is defined as an ectopic pregnancy in a region of the peritoneal cavity that does not include the fallopian tubes,ovaries,or their associated ligamentous structures.Many abdominal pregnancies are caused by secondary implantation in the peritoneal cavity after tubal abortion,rupture,or uterine rupture.Here,we report a case of abdominal pregnancy resulting from iatrogenic uterine perforation during the induced abortion of an early intrauterine pregnancy,which had been misdiagnosed as a ruptured corpus luteum cyst due to the sudden rupture of the abdominal gestational sac,complicating intra-abdominal hemorrhage.The true diagnosis was missed by vaginal ultrasound and confirmed by laparoscopic exploration.We discuss the details of the case management and review the relevant literature.©2023 Zhejiang University.

Abdominal Pregnancy with Hemorrhagic Placenta: About a Case at the Mother and Child Health Center of Zinder

Background: In developing countries maternal mortality and morbidity are most often due to the late to consult, poverty and ignorance. Added to this is, the under-medicalization of the health system. The objective of study is to report a case of late consultation and its consequences and make recommendations to improve: case of abdominal pregnancy with hemorrhagic placenta at the Health and Mother Center (CSME) in Zinder/Niger. Clinical Observation: We describe a case of abdominal pregnancy with hemorrhagic placenta in a 24-year-old woman, without profession, resident in the city of Zinder with a low economic level, consulted for abdomino-pelvic pain. She had a notion of amenorrhea for 5 months without any consultation made. She was pale, feverish and had abdominal pain. Ultrasound revealed a 23-week-old fetus and an empty uterus. The diagnosis was abdominal pregnancy. A laparotomy was performed and a The morbidity was hysterectomy and anemia. The postoperative period course was complicated with anemia. The patient was cured on the 9th day with a good vital prognosis. Conclusion: Abdominal pregnancy occurred in a patient who presented a risk factor. Ultrasound was the key diagnostic test. Surgery was the treatment of choice and the prognosis depends on the earliness of the consultation. Community awareness and early consultation with health services can improve the prognosis of abdominal pregnancy.

Abdominal Pregnancy: Epidemiological, Diagnostic, Therapeutic and Prognostic Aspects: A Case Report from the Yaounde Central Hospital (Cameroon)

Abdominal pregnancy (AP) is a relatively rare and potentially serious form of ectopic pregnancies (EPs). We report the case of a haemorrhagic abdominal pregnancy at 15 weeks of amenorrhea complicated by hypovolaemic shock, with a favorable outcome. Our aim is to outline the epidemiological, clinical, therapeutic and prognostic features of this condition.

Abdominal Pregnancy: About a Case Observed at the Maternity of the Community University Hospital Center, Bangui, Central African Republic

Abdominal pregnancy is a life threat to both mother and fetus requiring surgery regardless of the age of pregnancy. We report a case of abdominal pregnancy, delivered by laparotomy with a live newborn. This is a 31-year-old woman with 34 weeks and 2 days of amenorrhea whose ultrasound showed an abdominal pregnancy. Laparotomy extracted a newborn female weighing 3000 grams with APGAR at birth rated at 7/10 at one minute. The postoperatives were simple. The patient was discharged on the 14th postoperative day on 20 mg methrotrexate injection once a week for four weeks.

Successful Management of Rare Advanced Abdominal Pregnancy with Severe Preeclampsia: A Case Report and Literature Review

Background: Abdominal pregnancy is a rare ectopic pregnancy in which the baby grows up in the peritoneal cavity exclusive of tubal, ovarian, or intraligamentary implantations. Abdominal pregnancy has very high maternal and fetal morbidity and mortality. Therefore, early recognition and prompt management remain challenges for the treating physician. A thorough examination of the newborn is critical to rule out congenital anomalies. We reported a 24-year-old woman primigravida 40 weeks post-date with spontaneous conception who was admitted to the hospital with complaints of diffuse abdominal pain, symptoms, and signs of severe preeclampsia (headache, vomiting, high blood pressure, blurred vision, and swelling of the feet, ankles, face, and hands). Moreover, she had recurrent vaginal spotting, nausea, loss of appetite, and occasional vomiting. She was diagnosed with a progressive abdominal pregnancy later. A live male fetus stained with meconium was removed from the abdominal cavity, and the placenta was completely removed without significant blood loss. Conclusion: Abdominal pregnancy is a rare ectopic pregnancy requiring high clinical suspicion, early identification, and prompt management to avoid maternal morbidity and mortality. Abdominal pregnancy can be prevented by avoiding miscarriage and treating adhesions and chronic inflammatory diseases.

Management of a Second-Trimester Abdominal Pregnancy: A Case Report and Review of the Literature

Introduction: The abdominal pregnancy is a rare pathology that can threaten the vital prognosis of the mother. The positive diagnosis is difficult to establish. It is most often made in an acute context, leading to a high fetomaternal morbidity and mortality. Our objective is to recall the diagnostic approach and optimal management of this condition. Case report: We present the case of an abdominal pregnancy at 18 weeks of amenorrhea with partial placental abruption in a 26-year-old patient who presented with abdominal pain in emergency obstetrical department of university hospital center of Agadir. The ultrasound revealed the presence of an evolving abdominal pregnancy. The MRI allowed precisely the localization of the placenta and its relationship with the surrounding organs. A laparotomy revealed the insertion of the placenta on the right adnexa. The right adnexectomy allowed removal of the placenta without incident. Conclusion: Abdominal pregnancy is difficult to diagnose. It is essential to be well informed about the clinical and ultrasonographic semiology of this pregnancy, in order to avoid operative surprises and to ensure the appropriate treatment.

Calcified Abdominal Pregnancy with Five Years of Evolution (Lithopedion): A Case Report

Lithopedion is a rare phenomenon resulting from an extra-uterine pregnancy that advances to fetal demise and calcification and there are less than 300 cases reported in 400 years of medical literature. This rare condition was first described by a surgeon of the Arabic era of medicine in the 10th century. This case report is a 26-year-old, multiparous woman who had presented a lower abdominal pain for long time and she had never attended in pre-natal clinic. She came to our hospital with pain and tumoral mass in infra-umbilical area and then we referred to radiology center, after that ultrasound examination of radiology center demonstrated an extra-uterine abdominal 30-week pregnancy measuring the femoral length, this for first diagnosis of radiology center. After laparotomy was performed we met an oval shaped mass that attached the omentum in peritoneal cavity and this mass was a fetus retention of 5 years without calcified ovular membranes but the fetus was calcified so this type is called lithopedion that describes according to the Kuechenmeister classification in 1881. She made good post-operative recovery after extraction the stone baby.

Abdominal Advanced Pregnancy: A Case Report

Abdominal advanced pregnancy is a rare form of ectopic pregnancy. The diagnosis can be difficult, especially in advanced forms. The management is mainly surgical. The materno-fetal mortality is very high with a high risk of bleeding. We report a case of a 22 years old primiparous who presented an abdominal pregnancy with intraoperative discovery. Through this case managed in our structure, we will present the diagnostic and management difficulties.

Advanced Abdominal Ectopic Pregnancy: A Case Report

A 35-year-old unbooked gravida 6 para 5+0 woman with 4 living children, who was unsure of her last menstrual period but she adjudged her index pregnancy to be term. She presented to the emergency unit with six months history of progressive weight loss, difficulty in breathing and abdominal pain that suddenly got worse about two days prior to presentation after an attempted external cephalic version by a traditional birth attendant. Ultrasound diagnosed abdominal pregnancy. An emergency laparotomy revealed collapsed fetal membranes with a rent of about 10 centimeters in diameter on the right and straw-colored amniotic fluid of about 2 litres in peritoneal cavity. A live male fetus was delivered with birth weight of 2.9 kilograms. The umbilical cord was cut and tied short close to the placenta which was left in situ and methotrexate was given. Post operative condition was satisfactory and patient had a brisk recovery. She was adequately counseled and discharged home on the 12th day after surgery and followed up subsequently.