MR Imaging in Advanced Abdominal Pregnancy

Wagner, A.; Burchardt, A.-J.

doi:10.1080/02841859509173377

Cited by 16 publications

(6 citation statements)

References 9 publications

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“…Abdominal pregnancy is an extremely rare form of EP, accounting for approximately 0.1% of all EP, and can be primary or secondary to a tubal pregnancy that aborts out of the fimbria and reimplants in the peritoneal cavity [25,26]. Since the pregnancy can potentially continue to term, this condition is associated with considerably high morbidity and mortality due to delayed diagnosis and usually requires surgical intervention.…”

Section: Abdominal Pregnancymentioning

confidence: 98%

MR features of ectopic pregnancy

2007

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Ectopic pregnancy (EP), in which a fertilized ovum implants outside the uterine cavity, is the leading cause of pregnancy-related death in the first trimester. EP is usually suspected by a positive pregnancy test and an empty uterus on transvaginal sonography (TVS). Although TVS is the initial modality of choice, it may occasionally fail to demonstrate the implantation site. When TVS findings are indeterminate, magnetic resonance imaging (MRI) may provide better delineation of the focus of EP owing to its excellent tissue contrast. The key MRI features of EP include gestational sac (GS)-like structures that typically appear as a cystic sac-like structure, frequently associated with surrounding acute hematoma of distinct low intensity on T2-weighted images. In tubal pregnancy, an enhanced tubal wall on postcontrast images may be another diagnostic finding. Ruptured EP is inevitably associated with acute hematoma outside these structures. In intrauterine EP, recognition of the relationship between GS-like structure and the myometrium can aid in differentiating from normal pregnancy. Diagnostic pitfalls include heterotopic pregnancy, decidual changes in endometrial cyst and theca lutein cysts mimicking GS-like structures. Knowledge of a spectrum of clinical and MRI features of EP is essential for establishing an accurate diagnosis and determining appropriate management.

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Section: Abdominal Pregnancymentioning

confidence: 98%

MR features of ectopic pregnancy

2007

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“…Absence of a uteroplasental fistula, 3. Attachement exclusively to a peritoneal surface early enough in gestation to eliminate the likelihood of reimplantation after tubal abortion (7). Usual sites for implantation of an abdominal pregnancy are intraabdominal organs especially the bowel or mesentery or the peritoneum.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic management of primary abdominal pregnancy: a case report

Altay¹,

Dündar²,

Erol³

et al. 2010

J Turkish German Gynecol Assoc

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This is a case report of a primary abdominal pregnancy managed by laparoscopic intervention. A 22 year old, gravida 1, woman was admitted to our emergency room with vaginal bleeding and pain in lower abdomen. She was 4 weeks pregnant according to her last menstrual period. She had undergone right salpingoophorectomy previously. Pelvic examination revealed cervical motion tenderness, bilateral adnexal tenderness and rebound tenderness. Her vital signs were normal. Beta hCG was 15826 IU/ml and hemoglobin was 10.0 g/dl. Transvaginal sonography showed an endometrium of 3 mm thickness and free fluid in the pelvis. Upon admission to the Early Pregnancy Clinic, abdominal pain became worse and hemoglobin decreased to 8.0 g/dL. Therefore, we performed a laparoscopy which showed that the uterus, left tube and ovary were completely normal with absence of the right ovary and tube. Approximately 500 cc blood was aspirated from the pelvis. Between the right sacrouterine ligament and rectum, there was a bleeding area 2 cm in width which was removed with forceps and sent for frozen pathological examination,which revealed 'placental tissue fragments'. Endometrial sampling was reported to be 'secretory endometrium'. A rapid decrease in the beta HCG post operative titer confirmed the resolution of the pregnancy. Primary abdominal pregnancy is extremely rare. The diagnosis is confirmed according to Studdiford's criteria. In the literature, there only a few cases of abdominal pregnancy in which laparoscopic procedure has been used effectively as treatment. However, laparoscopic procedure is usually successful in treatment of abdominal pregnancy if the gestational age is early enough.

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“…They have helped significantly to improve the diagnostic accuracy. Ultrasonography was used in the management of the third and sixth cases in the series, but the absolute diagnosis of AAP by ultrasound is missed in half of cases [21][22][23]. A high index of suspicion based on the clinical features at presentation, coupled with meticulous ultrasonography, will improve the diagnostic accuracy better than one of the two approaches alone.…”

Section: Discussionmentioning

confidence: 99%