Morales HS, Díaz VMF, Puello TE, Morales HJ, Basavilvazo RMA, Cruz CPR, Hernández VM

Language: Spanish
References: 11
Page: 615-620
PDF size: 213.84 Kb.

ABSTRACT

Abdominal pregnancies are the implantation of gestation in some of the abdominal structures. This kind of pregnancies represents sevenfold maternal death risk than tubarian ectopic pregnancies, and 90-fold death risk than normal ones. Previous cases have erroneously reported as abscess in Douglas punch, and frequently result in obitus or postnatal deaths. We report a case of a patient with 27 years old, and diagnosis of 25.2 weeks of pregnancy, prior placenta and anhidramnios, referred due to difficult in uterine contour delimitation, easy palpation of fetal parts, cephalic pole in left hypochondrious and presence of mass in hypogastria, no delimitations, pain with mobilization, no transvaginal bleed and fetal movements. Interruption of pregnancy is decided by virtue of severe oligohidramnios, retardation in fetal intrabdominal growth, and recurrent maternal abdominal pain. Surgical intervention was carried out for resolution of the obstetrical event, in which was found ectopic abdominal pregnancy with bed placental in right uterine horn that corresponded to a pregnancy of 30 weeks of gestation. Abdominal pregnancy is still a challenge for obstetrics due to its diagnosis and treatment. Early diagnosis is oriented to prevent an intrabdominal hemorrhage that is the main maternal cause of mortality.

REFERENCES

1. Martin JN, Sessums JK, Martin RW, Pryor JA, Morrison JC. Abdominal pregnancy: current of management. Obstet Gynecol 1988;71:549-57.

2. Atrash HK, Friede A, Hogue CJ. Ectopic pregnancy mortality in the United States 1970-1983. Obstet Gynecol 1987;70:817-22.

3. Naim NM, Ahmad S, Siraj HH, Ng P, et al. Advanced abdominal pregnancy resulting from late uterine rupture. Obstet Gynecol 2008;111:502-4.

4. Sherer DM, Dalloul M, Gorelick C, Kheyman M, et al. Unusual maternal vasculature in the placental periphery leading to the diagnosis of abdominal pregnancy at 25 week´s gestation. J Clin Ultrasound 2007;35:268-73.

5. García-Benitez CQ, Lira PJ, Dueñas RJJ. Manejo conservador del embarazo ectópico abdominal secundario. Reporte de un caso con revisión de la literatura. Ginecol Obstet Mex 2003;71:181-6.

6. Plete RA, Adama AN, Tadan R, Ahitare H. Ecampsia in advanced abdominal pregnancy. Niger J Clin Pract 2007;10:343-5.

7. Zhang J, Li F, Sheng Q. Full-term abdominal pregnancy: a case report and review of the literarure. Gynecol Obstet Invest 2008;65:139-41.

8. López LE, Zamara MF, Buitrón GR. Embarazo ectópico abdominal con resultado de nacido vivo. Reporte de un caso. Ginecol Obstet Mex 2001;69:151-4.

9. Rana A, Gurung G, Rawal S, Bista KD, et al. Surviving 27 weeks fetus expelled out of the ruptured rudimentary horn and detecte a month later as a secondary abdominal pregnancy. J Obstet Gynaecol Res 2008;34:247-51.

10. Shaw SW, Hsu JJ, Chueh HY, Han CM, et al. Case reports. Advanced abdominal pregnancy. Canad M A J 1946:54:483-5.

11. Reid R. A case of abdominal pregnancy. BMJ 1938;18:1301-3