Management of primary abdominal pregnancy: twelve years of experience in a medical centre

Abstract

Our experience shows a trend toward better management of primary abdominal pregnancy with laparoscopy. These patients had shorter operative time, reduced blood loss, and fewer days in hospital then patients treated with laparotomy. Choice of management should depend on the patient's condition, gestational age of the pregnancy, and the physician's clinical experience.

Early Abdominal Ectopic Pregnancies: A Systematic Review of the Literature

“…This was the most frequent location for abdominal pregnancies with 55 cases identified [5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48]. The average age of the patient was 31 with a gestational age of 9 weeks for initial treatment and parity of 1.6.…”

“…There were 25 reports from 24 different references of an abdominal pregnancy being primarily implanted on the omentum [42,93,94,95,96,97,98,99,100,101,102,103,104,105,106,107,108,109,110,111,112,113,114,115]. The patient’s average age at initial presentation was 27 (range 13–36) with the average gestational age at diagnosis of 7 weeks and 2 days (range 4–16 weeks) and parity of 1.3.…”

“…There were 54 cases of pregnancies implanted on the uterus or adnexa [2,24,28,34,42,44,49,50,51,52,53,54,55,56,57,58,59,60,61,62,63,64,65,66,67,68,69,70,71,72,73,74,75]. The average maternal age was 29.6 years, with gestational age of 11 weeks 2 days and parity of 0.8.…”

“…Both the anterior and posterior implantations were generally treated by exploratory laparotomy, but 12 cases were treated laparoscopically [10,14,17,18,29,31,37,42,45]. One patient had a vaginal hysterectomy 2 months prior to surgery [6].…”

Clinical Treatment of Unruptured Ectopic Pregnancy

“…The traditional management involves a laparotomy with removal of the fetus with or without placental tissue (Ayinde et al, 2005). Recently, there have been several reports of laparoscopic management (Shaw et al, 2007). One of the problems associated with the removal of abdominal pregnancies after the first trimester is the risk of massive blood loss from the placental bed.…”