Minimally Invasive Management of an Advanced Abdominal Pregnancy

Rahaman, Jamal; Berkowitz, Richard L.; Mitty, Harold A.; Gaddipati, Sreedhar; Brown, Barry L.; Nezhat, Farr

doi:10.1097/01.aog.0000127946.14387.48

Cited by 77 publications

(65 citation statements)

References 8 publications

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“…When destruction occurs too quickly upon methotrexate treatment, the risk of sepsis and death ensues due to the formation of large amounts of necrotic tissue. This might be avoided by using methotrexate judiciously with the administration of lower doses with less frequent intervals; thereby allowing the slow resorption of the placenta left in the abdominal cavity (26). In the present case, emergency laparotomy was performed because of acute abdomen.…”

Section: Discussionmentioning

confidence: 82%

A 34-week ovarian pregnancy: case report and review of the literature

Meşeci¹,

Güzel²,

Zemherı³

et al. 2013

J Turkish German Gynecol Assoc

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Advanced ovarian pregnancy is a quite rare condition. Due to the high maternal and neonatal mortality rates, early and accurate diagnosis is vital. Lack of sufficient data led us to search the literature and compile available data on the topic. A 33-year-old woman presented with acute abdomen at 34 weeks of gestation. She underwent laparotomy, which revealed a live foetus surrounded by an intact amnion membrane located in the left adnexal area. The patient delivered a live female infant. Heavy bleeding from the placenta necessitated salpingo oophorectomy. Histological examination of the removed tissue confirmed the ovarian pregnancy. Because of the substantial risk of adverse outcomes, this condition should be borne in mind, especially in cases presenting with acute abdomen during pregnancy. (J Turkish-German Gynecol Assoc 2013; 14: 246-9) Key words: Abdominal pregnancy, ectopic pregnancy, ovarian pregnancy Received: 06 November, 2012 Accepted: 23 January, 2013 Available Online Date: 10 July, 2013 İkinci ve üçüncü trimester over gebeliği oldukça nadir bir durumdur. Yüksek maternal ve neonatal mortalite oranları nedeniyle erken ve doğru tanı konulması hayat kurtarıcıdır. Karşılaştığımız ender rastlanan olgu ve konu ile ilgili yeterli bilginin bulunmayışı bizi ikinci ve üçüncü trimester over gebeliği hakkındaki literatürü irdelemeye yöneltti. Otuz üç yaşında kadın hasta, gebeliğin otuz dördüncü haftasında akut abdomen bulgularıyla kliniğimize başvurdu. Laparatomide sol adneksial alanda intakt amniotik membran ile çevrili, içinde canlı fetusun bulunduğu ekstrauterin gebelik tespit edildi. Canlı bir kız bebek doğurtuldu. Plasental alandaki şiddetli kanama nedeniyle salpingo ooferektomi yapıldı. Histopatolojik sonuç over gebeliğiyle uyumlu bulundu. Özellikle ilk trimesterden sonra akut batın bulgularıyla başvuran hastalarda, ayırıcı tanıda over gebeliği akılda tutulmalıdır.

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Section: Discussionmentioning

confidence: 82%

A 34-week ovarian pregnancy: case report and review of the literature

Meşeci¹,

Güzel²,

Zemherı³

et al. 2013

J Turkish German Gynecol Assoc

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“…Pre-operative arterial embolisation and methotrexate therapy have been advocated [7]. Post-operative methotrexate has been recommended by some but rapid placental destruction may lead to accumulation of necrotic debris inviting bacterial growth [8].…”

Section: Discussionmentioning

confidence: 99%

Challenges in the Management of a Case of Secondary Abdominal Pregnancy

Singh¹,

Mishra²,

Motwani³

et al. 2015

OJOG

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Introduction: Abdominal pregnancy, one of the rare forms of ectopic pregnancy demands a high index of suspicion for its timely diagnosis and intervention so as to prevent both maternal and neonatal complications. We presented a case of secondary abdominal pregnancy which was missed at the first instance at a private centre and came to us with nonspecific abdominal symptoms after an attempted termination of pregnancy by surgical means (dilation and curettage). Case presentation: A 24-year-old third gravida with two live issues at 10-week gestation came to us with complaints of pain lower abdomen, vomiting and inability to pass stool. She gave history of undergoing dilation and curettage (D&C) at a private hospital for termination of pregnancy about 20 days back. After thorough work-up and investigations, the diagnosis of secondary abdominal pregnancy was established and she was taken up for exploratory laparotomy with the removal of fetus with placenta. The patient progressed well with the postoperative period remaining uneventful. Conclusion: Secondary abdominal pregnancy poses as a challenge to clinicians working with limited diagnostic facilities. The condition may be life threatening if not handled meticulously.

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“…This type of pregnancy is a rare but life threatening condition, which poses considerable challenge particularly to care provider in developing countries 2 . It is account for 1% percent of ectopic pregnancies and maternal mortality rate as high as 20% 3,4 .…”

Section: Introductionmentioning

confidence: 99%

Broad Ligament Pregnancy Through A Cesarean Scar : An Unusual One

Yeasmin

Begum

Uddin

2016

Chatt Maa Shi Hosp Med Coll J

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Broad ligament pregnancy is an extremely rare event with high risk of maternal mortality. Diagnosis is often late in our setting and finally made during laparotomy. It is a type of secondary abdominal pregnancy.We present a case which remained undiagnosed throughout her pregnancy till she reached to 35 weeks and unfortunately had intrauterine fetal demise when she reported to our hospital.After admission her pregnancy was induced with misoprostol but did not response. On clinical suspicion,repeat ultrasound evaluation was done by senior sinologist, which picked up the diagnosis of abdominal pregnancy. On laparotomy a broad ligament pregnancy was found with a rent in the previous Cesarean scar towards the gestational sac in the broad ligament.

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Minimally Invasive Management of an Advanced Abdominal Pregnancy

Abstract: This report demonstrates successful minimally invasive management of an advanced abdominal pregnancy with a multimodal approach that included preoperative arterial embolization, laparoscopically assisted delivery, and judicious use of postoperative methotrexate.

Cited by 77 publications

References 8 publications

A 34-week ovarian pregnancy: case report and review of the literature

A 34-week ovarian pregnancy: case report and review of the literature

Challenges in the Management of a Case of Secondary Abdominal Pregnancy

Broad Ligament Pregnancy Through A Cesarean Scar : An Unusual One

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