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Federación Mexicana de Ginecología y Obstetricia, A.C.

2024, Number 10

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Ginecol Obstet Mex 2024; 92 (10)

Experience in the medical care of abdominal ectopic pregnancy

Miranda FAF

Language: Spanish
References: 14
Page: 407-414
PDF size: 193.19 Kb.


ABSTRACT

Objective: To know the experience in the medical care of patients with abdominal ectopic pregnancy.
Materials and Methods: Descriptive and retrospective study carried out at the Instituto Nacional Materno Perinatal, Lima, Peru in patients with a diagnosis of abdominal ectopic pregnancy attended between 2021 and 2023. Data were collected from medical records. Statistical analysis was performed using SPSS 24.
Results: Seven cases of patients with abdominal ectopic pregnancy were included. The mean age of the patients was 31.3 years. Only three patients had any risk factors. The mean gestational age was nine weeks. Five of the seven patients presented with abdominal pain as the only symptom. Preoperative diagnosis was established in three of the seven patients. Four patients had hemoperitoneum. The most common site of implantation was the broad ligament (in 3 of the 7 patients). Treatment was operative in all cases. One patient had hemoperitoneum as a postoperative complication due to bleeding from the placental bed.
Conclusions: Abdominal ectopic pregnancy has a high maternal morbidity and mortality; seven cases have been reported in our institution in three years. The clinical picture depends on the site of implantation, most of them have hemoperitoneum and abdominal pain, so the diagnosis and treatment are made simultaneously by surgery. Prenatal control is fundamental because ultrasound is sufficient to establish the diagnosis and, in special cases, magnetic resonance imaging is very useful. If the diagnosis is made in time, conservative or surgical treatment can be offered depending on the patient's condition, thus reducing complications.


REFERENCES

  1. Chen Y, Peng P, Li C, Teng L, et al. Abdominal pregnancy:a case report and review of 17 cases. Arch Gynecol Obstet 2023; 307: 263-74. https://doi.org/10.1007/s00404-022-06570-9

  2. Abdullah L, Alsulaiman SS, Hassan M, Ibrahim HS, etal. Abdominal pregnancy: a case report. Ann Med Surg(Lond) 2023; 85 (2): 302-305. http://doi.org/10.1097/MS9.0000000000000245

  3. Elías E, Huerta S, Campos del Castillo K, Coronado A,et al. Embarazo ectópico abdominal: Reporte de doscasos. Rev Peru Ginecol Obstet 2021; 67 (1). https://doi.org/10.31403/rpgo. v67i2306

  4. Gutiérrez Y, Alvir A, Campillos M, Garrido F, et al. Embarazoectópico abdominal. Diagnóstico y tratamiento médico conmetotrexato. Prog Obstet Ginecol 2011; 54 (5): 257-60.https://doi.org/1016/j.pog.2011.02.017

  5. Herrera O, Rodríguez C, Niebla C, Torres B, et al. Embarazoectópico abdominal: protocolo de tratamiento combinado.Reporte de un caso. Ginecol Obstet Mex 2019; 87 (4): 262-67. https://doi.org/10.24245/gom. v87i4.2787

  6. Rohilla M, Joshi B, Jain V, Neetimala, et al. Advanced abdominalpregnancy: a search for consensus. Review of literaturealong with case report. Arch Gynecol Obstet 2018;298 (1): 1-8. https://doi.org/10.1007/s00404-018-4743-3

  7. Shaw S, Hsu J, Chueh H, Han C, et al. Management of primaryabdominal pregnancy: twelve years of experience ina medical centre. Acta Obstet Gynecol Scand 2007; 86 (9):1058-62. https://doi.org/10.1080/00016340701434476

  8. Yoder N, Tal R, Martin J. Abdominal ectopic pregnancyafter in vitro fertilization and single embryo transfer: a casereport and systematic review. Reprod Biol Endocrinol 2016;14 (1): 69. https://doi.org/10.1186/s12958-016-0201-x

  9. Huang K, Song L, Wang L, Gao Z, et al. Advanced abdominalpregnancy: an increasingly challenging clinical concern forobstetricians. Int J Clin Exp Pathol 2014; 7 (9): 5461-72.

  10. American College of Obstetricians and Gynecologists(ACOG) Practice Bulletin No. 193: Tubal Ectopic Pregnancy.Obstetrics and Gynecology 2018; 131 (3): e91-e103.https://doi.org/10.1097/AOG.0000000000002464

  11. Tolefac P, Abanda M, Minkande J, Priso E. The challenge inthe diagnosis and management of an advanced abdominalpregnancy in a resource-low setting: a case report. J MedCase Rep 2017; 11 (1): 199. https://doi.org/10.1186/s13256-017-1369-1

  12. Poole A, Haas D, Magann EF. Early abdominal ectopicpregnancies: a systematic review of the literature. GynecolObstet Invest 2012; 74 (4): 249-60. https://doi.org/10.1159/000342997

  13. Gidiri M, Kanyenze M. Advanced abdominal ectopicpregnancy: lessons from three cases from Zimbabwe anda literature appraisal of diagnostic and management challenges.Women´s Health (Lond) 2015; (3): 275-9. https://doi.org/10.2217/whe.15.3

  14. Nassali M, Benti T, Bandani N, Musinguzi E. A case reportof an asymptomatic late term abdominal pregnancy with alive birth at 41 weeks of gestation. BMC Res Notes 2016; 9:31. https://doi.org/10.1186/s13104-016-1844-6




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