Antepartum uterine rupture in a twin gestation presenting as an advanced extrauterine pregnancy in a patient with a previous lower segment Caesarean section

Ngene, Nnabuike Chibuoke; Naidoo, Thinagrin D; Titus, Mokete Joseph; Moodley, Jagidesa; Craib, Shirley; Stutterheim, James

doi:10.1177/0049475514524954

Cited by 7 publications

(6 citation statements)

References 7 publications

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“…It is also noted that transvaginal ultrasound in the first trimester of pregnancy may improve the diagnosis of extrauterine pregnancy. Importantly, in patients with previous major uterine surgery, differential diagnosis of abdominal pregnancy must include a uterine rupture with extrusion of the products of conception into the peritoneal cavity [15]. Our patient had not had an ultrasound in either the first or second trimesters.…”

Section: Discussionmentioning

confidence: 87%

Late abdominal pregnancy in a post-conflict context: case of a mistaken acute abdomen - a case report

Paluku

Kalole²,

Furaha

et al. 2020

BMC Pregnancy Childbirth

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Background: Abdominal pregnancies have been reported in both high-income countries as well as low-and middle-income countries. They are frequently missed in routine antenatal care in resource-limited settings and delayed diagnosis is usually associated with poor fetal and maternal outcomes including death. This case report is among the first from eastern Democratic Republic of Congo (DRC), a post-conflict region. Case presentation: In this case study, we present a 25 year-old primigravida patient referred to HEAL Africa hospital for management of an acute abdomen at 33-weeks gestation. Her chief complaint was severe abdominal pain associated with each fetal movement for a period of 1 week prior to admission. A diagnosis of peritonitis was made. Emergency laparotomy revealed a normal live 2 kg baby with placental implantation on the greater omentum and small intestine mesentery. The placenta was not removed. Both maternal and fetal outcomes were good. Conclusion: Abdominal pregnancy with a normal live fetus at such an advanced gestational age is rare. This case reminds clinicians that abdominal pregnancy remains a differential diagnosis for painful fetal movements.

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Section: Discussionmentioning

confidence: 87%

Late abdominal pregnancy in a post-conflict context: case of a mistaken acute abdomen - a case report

Paluku

Kalole²,

Furaha

et al. 2020

BMC Pregnancy Childbirth

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“…An AAP may be missed even after repeated ultrasound scanning if a thorough evaluation is not done, which was evident in many previous case reports. CT and MRI are useful for confirming the diagnosis, distinguishing anatomic relationships and potential vascular connections, and assessing placental adherence [ 4 ]. Our patient presented late, neglecting all the unusual symptoms in pregnancy, and she lives in an area where advanced imaging technologies are lacking.…”

Section: Discussionmentioning

confidence: 99%

“…A high index of suspicion and thorough clinical and ultrasound examinations are crucial to diagnosing abdominal pregnancy. Computed tomography (CT) and magnetic resonance imaging (MRI) may help in making the diagnosis and planning intra-operative care [ 4 ]. Timely surgical intervention is imperative to preventing maternal and fetal catastrophe.…”

Section: Introductionmentioning

confidence: 99%

A pre-operatively diagnosed advanced abdominal pregnancy with a surviving neonate: a case report

Gudu

Bekele

2015

J Med Case Reports

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IntroductionAbdominal pregnancy is a rare form of ectopic pregnancy with a high rate of maternal and fetal complications. Most of the reported cases are diagnosed in early trimesters, usually after presenting with complications. Advanced abdominal pregnancy poses a huge diagnostic and management challenge, particularly in low-income countries. A term abdominal pregnancy diagnosed pre-operatively and resulting in a surviving neonate is quite rare.Case presentationA 35-year-old, para 2, unbooked, Ethiopian Somali woman presented with amenorrhea of 9 months’ duration, abdominal pain, and painful fetal movements of 4 months’ duration. Her physical examination revealed a uterus sized 36 weeks’ gestation with easily palpable fetal parts. Her laboratory test results were unremarkable except for mild anemia. Her ultrasound findings were suggestive of abdominal pregnancy. Laparotomy was done to salvage an alive healthy neonate from the peritoneum with removal of placenta implanted on the right broad ligament. The mother had a smooth post-operative course.ConclusionsAn advanced abdominal pregnancy diagnosed pre-operatively with delivery of a surviving neonate is rare. A high index of suspicion and thorough clinical and ultrasound evaluation are crucial to making an early diagnosis. This is particularly important in areas where advanced imaging technologies are not readily available. Timely surgical intervention is imperative to avert maternal and fetal complications.Electronic supplementary materialThe online version of this article (doi:10.1186/s13256-015-0712-7) contains supplementary material, which is available to authorized users.

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“…There are rising concerns regarding the short-term complications and long-term risks of CS, including placental implantation and uterine rupture in the next pregnancy ( 3 ). It is well established that pregnancy risks dramatically increase with twin pregnancies than singleton pregnancies ( 4 ), especially in patients with scarred uterus ( 5 ). There is an urgent need to reduce the multiple pregnancies rate in patients with the previous cesarean delivery(CD) ( 6 ).…”

Section: Introductionmentioning

confidence: 99%

Pregnancy and Perinatal Outcomes of Patients With Prior Cesarean Section After a Single Embryo Transfer in IVF/ICSI: A Retrospective Cohort Study

Wang

Lü

et al. 2022

Front. Endocrinol.

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ObjectiveTo study the influence of the previous cesarean section on the pregnancy outcomes and perinatal outcomes in single embryo transfer (SET) cycles in an in vitro fertilization/intracytoplasmic sperm injection-embryo transfer (IVF/ICSI-ET) setting compared to those with previous vaginal delivery (VD). In addition, the association between fertility outcomes and different cesarean scar defect (CSD) sizes was studied.MethodThis was a retrospective cohort study conducted in the Reproductive Center of the First Affiliated Hospital of Nanjing Medical University. A total of 4,879 patients with previous delivery history undergoing SET were included between January 2015 and April 2019. Patients were divided into the VD group and cesarean delivery (CD) group according to different modes of previous delivery. The primary outcome was live birth rate. The pregnancy outcomes of CD were analyzed as a subgroup and the relationship between pregnancy outcomes as well as the different sizes of CSD were explored by logistic regression analysis.ResultsThere were no significant differences in live birth rate, clinical pregnancy rate, and miscarriage rate between the CD group and VD group. The incidence rates of pregnancy complications such as pregnancy hypertension, gestational diabetes mellitus, placenta abnormalities, premature rupture of membrane, and postpartum hemorrhage were similar in the two groups. Live birth rate was significantly lower in the CSD group (23.77% vs 37.01%, aOR: 0.609, 95% CI: 0.476-0.778) comparing to patients without CSD. There were also significant differences in clinical pregnancy rate (37.52% vs 47.64%, aOR: 0.779, 95%CI: 0.623-0.973) and miscarriage rate (34.55% vs 20.59%, aOR: 1.407, 95%CI:1.03-1.923). Large size CSD significantly decreased live birth rate (13.33% vs 26.29%, aOR: 0.422, 95%CI: 0.197-0.902) and clinical pregnancy rate (25.33% vs 40.09%, aOR: 0.503, 95%CI: 0.272-0.930) compared with small size CSD.ConclusionFor women with previous cesarean sections, the pregnancy outcomes were similar to those with previous VD without increased perinatal complications following SET. The presence of CSD was associated with a marked reduction in live birth rate, especially in patients with large size CSD.

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Antepartum uterine rupture in a twin gestation presenting as an advanced extrauterine pregnancy in a patient with a previous lower segment Caesarean section

Cited by 7 publications

References 7 publications

Late abdominal pregnancy in a post-conflict context: case of a mistaken acute abdomen - a case report

Late abdominal pregnancy in a post-conflict context: case of a mistaken acute abdomen - a case report

A pre-operatively diagnosed advanced abdominal pregnancy with a surviving neonate: a case report

Pregnancy and Perinatal Outcomes of Patients With Prior Cesarean Section After a Single Embryo Transfer in IVF/ICSI: A Retrospective Cohort Study

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