Primary twin omental pregnancy: report of a rare case and literature review

Silva, Benedito Borges da; Araujo, Emilson Pereira de; Cronemberger, José Nilson Damasceno; Santos, Adaniel Sousa dos; Lopes-Costa, Pedro Vitor

doi:10.1016/j.fertnstert.2008.03.038

Cited by 10 publications

(27 citation statements)

References 16 publications

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“…Some predisposing factors associated with abdominal pregnancy include endometriosis, multiparity, pelvic inflammatory disease, tubal damage, progesterone, intrauterine devices and assisted reproductive techniques. Mothers often do not have an abnormal trend in serial HCG as seen in other ectopic pregnancies 1 5. This is what was observed in the first trimester of this patient's pregnancy when her HCG levels increased as expected although an intrauterine pregnancy was not documented by ultrasound.…”

Section: Discussionsupporting

confidence: 78%

Role of serial MRI assessment in the management of an abdominal pregnancy

et al. 2013

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A 33-year-old woman was admitted to the hospital with an abdominal pregnancy at a gestational age of 20 weeks. An initial MRI mapping of fetal location and placental vascular invasion was obtained. The patient refused surgical intervention until fetal survival would be possible. Serial MRIs were essential in timing delivery and avoiding an emergency surgical situation. The baby was delivered at 24 weeks with the assistance of a multidisciplinary surgical team. The mother as well as the baby survived. This case report highlights the role of serial MRI evaluations in the diagnosis and expectant management of an abdominal pregnancy. It also highlights the importance of interdisciplinary communication for a successful outcome.

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Section: Discussionsupporting

confidence: 78%

Role of serial MRI assessment in the management of an abdominal pregnancy

et al. 2013

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“…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.…”

Section: Resultsmentioning

confidence: 99%

“…Omental ectopic pregnancies were more frequently treated by laparoscopy than abdominal ectopic pregnancies at all other locations. Of the 25 cases, 9 women [93,98,100,102,109,111,113,114,115] received a blood transfusion (36%) with an average blood loss of all cases of 1,160 ml (range minimal to 3,000 ml). All 25 patients presented with abdominal pain with 3 of the patients having pain in the epigastrium [94,111,113].…”

Section: Resultsmentioning

confidence: 99%

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Early Abdominal Ectopic Pregnancies: A Systematic Review of the Literature

Poole¹,

Haas

Magann

2012

Gynecol Obstet Invest

124

143

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Objective: To define abdominal ectopic pregnancy outcomes by both location and treatment. Methods: Literature review of abdominal pregnancies from 1965 to August of 2009. Ectopic pregnancy exclusions were interstitial, tubal, cervical, ovarian, or those beyond 20 weeks at diagnosis/treatment. Results: There were 511 cases identified with 225 meeting the inclusion criteria. There were 7 maternal deaths (3.0%) with 18 (8%) of the early abdominal ectopic pregnancies occurring with an intrauterine device in place. Mean gestational age at the time of treatment was 10 weeks 0 days and mean maternal age was 29.7 years. The average blood loss associated with treatment was 1,450 ml. The top three sites of early abdominal ectopic pregnancies were pouches around the uterus (24.3%), serosal surface of the uterus and tubes (23.9%), and multiple sites (12.8%). Primary surgical management was performed in 208 cases (87.8%). Nonsurgical adjuvant or primary therapy included intramuscular methotrexate, intralesional methotrexate, intracardiac KCl, and artery embolization. Conclusion: Abdominal pregnancies should be considered in all patients until an intrauterine location can be confirmed. Understanding treatment options by pregnancy location may be helpful in the management of this potentially life-threatening condition.

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“…Maternal mortality rates associated with abdominal pregnancy have been reported to be in the range 5-12 % [10,11]. In other report, maternal mortality rate of abdominal pregnancy is estimated to be 7-8 times as high as that of other types of ectopic pregnancy [12,13]. Fortunately, in the present case, because of the existence of conceptus in the pelvis and the thorough abdominal inspection, we detected the abdominal EP at an early stage and successfully treated the patient.…”

Section: Discussionmentioning

confidence: 99%

Simultaneous presentation of tubal and primary abdominal pregnancies following clomiphene citrate treatment

Baba

Endo

Ikeda

et al. 2012

Arch Gynecol Obstet

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Abdominal pregnancy is a rare condition that is potentially life-threatening for the mother. We present a case of simultaneous ectopic pregnancies (EPs) in the right fallopian tube and in the vesicouterine pouch. A 26-yearold woman had undergone prior ovulation induction with clomiphene citrate and human chorionic gonadotropin (hCG) at an outside hospital for unexplained infertility. The patient was referred to our hospital for a suspected ectopic pregnancy at 6 weeks gestation. Transvaginal ultrasonography detected a viable fetus at the anterior left side of the uterus; therefore, we suspected a left tubal pregnancy. However, laparoscopic surgery revealed that EPs were located in both the left vesicouterine pouch and in the right fallopian tube. Resection of the right salpinx and abdominal implant were performed. Histopathological examination confirmed the simultaneous presentation of a primary abdominal pregnancy and a right tubal pregnancy. After surgery, the patient's serum hCG level returned to normal. Concurrent EPs and abdominal pregnancy are very rare. However, it should be noted that reproductive technologies sometimes cause unusual clinical situations. A thorough abdominal inspection is needed.

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Primary twin omental pregnancy: report of a rare case and literature review

Cited by 10 publications

References 16 publications

Role of serial MRI assessment in the management of an abdominal pregnancy

Role of serial MRI assessment in the management of an abdominal pregnancy

Early Abdominal Ectopic Pregnancies: A Systematic Review of the Literature

Simultaneous presentation of tubal and primary abdominal pregnancies following clomiphene citrate treatment

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