Advanced abdominal pregnancy: a search for consensus. Review of literature along with case report

Rohilla, Manish; Joshi, Bharti; Jain, Vanita; Neetimala,; Gainder, Shalini

doi:10.1007/s00404-018-4743-3

Cited by 24 publications

(37 citation statements)

References 32 publications

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“…In our case series, the majority of live infants were delivered to patients with placental implantation on the external serosa of the uterine wall. This was also observed by Rohilla et al in her review of advanced abdominal pregnancies [37]. Individual cases who underwent planned conservative management of an abdominal EP with elective laparotomy and the birth of a healthy infant in the 34th GW have been described [25,70].…”

Section: Resultsmentioning

confidence: 53%

“…Their prevalence is estimated to be less than 0.01 % of all hospital births [30]. Many authors refer to pregnancies after the 20th GW as advanced abdominal pregnancies; it has been suggested that conservative management could be considered in these cases after weighing up the maternal risk of bleeding [37]. In our case series, the majority of live infants were delivered to patients with placental implantation on the external serosa of the uterine wall.…”

Section: Resultsmentioning

confidence: 89%

“…According to some authors, the extent of placental adhesion can be determined preoperatively using MRI [121]. Provided that placental blood supply can be safely disrupted, then resection of the placenta is recommended [37,40,57]. Otherwise the placenta can be left in situ, after the umbilical cord and fetal membranes have been removed [4].…”

Section: Resultsmentioning

confidence: 99%

“…The appropriate strategy for placental management is disputed in the literature and decisions must be made on a case-by-case basis according to the individual implantation site, the risk of bleeding, the patientʼs clinical condition, the physicianʼs surgical experience and the available medical resources 28 , 62 . Implantations on the omentum, spleen or liver are associated with a higher risk of bleeding, while the risk of bleeding appears to be lower if the placenta is located on the uterine serosa 37 . According to some authors, the extent of placental adhesion can be determined preoperatively using MRI 121 .…”

Section: Discussionmentioning

confidence: 99%

“…Das Plazentamanagement ist in der Literatur umstritten und sollte individuell in Abhängigkeit von der Implantationsstelle, dem Blutungsrisiko, dem klinischen Zustand der Patientin, den chirurgischen Fertigkeiten und medizinischen Ressourcen festgelegt werden 28 , 62 . Implantationen im Omentum, der Milz oder der Leber können zu einem größeren Blutungsrisiko führen, während dieses Risiko bei plazentarer Lokalisation an der Uterusserosa geringer scheint 37 . Das Ausmaß der plazentaren Adhäsion kann nach Angaben einiger Autoren präoperativ durch MRT festgestellt werden 121 .…”

Section: Diskussionunclassified

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Rare Ectopic Pregnancies – A Literature Review for the Period 2007 – 2019 on Locations Outside the Uterus and Fallopian Tubes

Eisner

Ebert²,

David

2020

Geburtshilfe Frauenheilkd

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The majority of ectopic pregnancies (EP) are tubal pregnancies, but other implantation sites outside the uterus and tubes are also found. These rare EP locations present a particular diagnostic and therapeutic challenge. We present an overview of potential very rare locations of ectopic pregnancies, their symptoms, diagnosis and treatment, based on a systematic analysis of case reports. A literature review of the databases PubMed, Livivo and Google Scholar for the period 2007 to 2019 was carried out. A total of 113 publications were included in our review. These studies describe EP implantations in the posterior cul-de-sac, on the uterine serosa and uterine ligaments, in the vicinity of almost all intraperitoneal organs, on the abdominal wall as well as in retroperitoneal sites. The most common presenting symptom was abdominal pain occurring in different locations. The diagnostic procedures included various imaging procedures and/or explorative surgery at different advanced stages of pregnancy. The most common and preferred option was laparotomy for surgical treatment. The placenta was successfully resected in the majority of cases. A rare EP location should be considered when making a differential diagnosis in patients of child-bearing age with abdominal pain.

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Section: Resultsmentioning

confidence: 53%

Section: Resultsmentioning

confidence: 89%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Diskussionunclassified

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Rare Ectopic Pregnancies – A Literature Review for the Period 2007 – 2019 on Locations Outside the Uterus and Fallopian Tubes

Eisner

Ebert²,

David

2020

Geburtshilfe Frauenheilkd

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Abdominal pregnancy: a case report and review of 17 cases

Chen

Peng

et al. 2022

Arch Gynecol Obstet

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Purpose To analyze the clinical characteristics of abdominal pregnancy, and to explore the diagnosis and prognosis of different treatment methods. Methods The cases of patients with abdominal pregnancy admitted to Peking Union Medical College Hospital between January 1, 1989 and January 1, 2021, were analyzed retrospectively. Results The median age of 17 patients was 34 years (22–42 years); the median gestational duration was 57 days (from 41 days to 32 weeks). Among all 17 patients, 15 (88.24%) presented with abdominal pain. The implantation sites of the gestational sac included the bladder peritoneal reflection, anterior wall of the rectum, omentum, serous membrane of the uterus, and inside or on the surface of uterosacral ligament. In all, only 29.41% cases (5/17) were diagnosed before surgery. All 17 patients were treated via surgery. Further, 58.82% (10/17) patients recovered without complications, 29.41% (5/17) developed fever, 5.88% (1/17) underwent reoperation because of intra-abdominal bleeding, and 5.88% (1/17) developed double lower limb venous thrombosis. All 17 patients survived. Conclusion The preoperative diagnosis rate of abdominal pregnancy is low. Planting sites in the pelvic peritoneum and pelvic organs are more common than the others. Laparoscopic surgery in the first trimester of pregnancy can achieve better therapeutic effects. However, the blood supply of the placenta should be fully evaluated before surgery. When it is expected that attempts to remove the placenta will cause fatal bleeding, the placenta can be left in place, but long-term close follow-up should be paid attention to.

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Nontubal ectopic pregnancies: overview of diagnosis and treatment

Sokalska

Rambhatla

Dudley

et al. 2023

Fertility and Sterility

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Advanced abdominal pregnancy: a search for consensus. Review of literature along with case report

Abstract: We are of considered opinion that conservative strategy is a feasible option in selected cases of advanced abdominal pregnancy yet there is a need of standardization of treatment principles for such cases to optimize fetomaternal outcome.

Cited by 24 publications

References 32 publications

Rare Ectopic Pregnancies – A Literature Review for the Period 2007 – 2019 on Locations Outside the Uterus and Fallopian Tubes

Rare Ectopic Pregnancies – A Literature Review for the Period 2007 – 2019 on Locations Outside the Uterus and Fallopian Tubes

Abdominal pregnancy: a case report and review of 17 cases

Nontubal ectopic pregnancies: overview of diagnosis and treatment

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