Abdominal pregnancy—a diagnosis never to miss

Victor Okey Dinwoke; Michael Oluchukwu Amara; Linda Uzo Amara; Victor Okey Dinwoke; Michael Oluchukwu Amara; Linda Uzo Amara

doi:10.3934/medsci.2022015

AIMS Medical Science

2022, Volume 9, Issue 2: 342-347. doi: 10.3934/medsci.2022015

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Case report

Abdominal pregnancy—a diagnosis never to miss

Enugu State University Teaching Hospital, Parklane, Enugu, Nigeria

Received: 29 December 2021 Revised: 22 April 2022 Accepted: 04 May 2022 Published: 10 May 2022

Background
Abdominal pregnancy is very rare, with only a few gynecologists being fortunate to encounter it all through their professional careers. It makes up only 1% of all ectopic pregnancies but has very high perinatal and maternal mortality of 95% and 18% respectively. Hemorrhagic and infectious complications account for these. Removal of the placenta at laparotomy is a big dilemma as torrential bleeding may ensue.

Case
We report the case of an undergraduate teenager who was referred with features of septicemia and anemia following unsafe vaginal instrumentation by a patent medicine dealer (a person without formal training in pharmacy but sells orthodox medications on retail basis) in a bid to terminate an extrauterine pregnancy. Ultrasonography confirmed a nonviable abdominal pregnancy of 20 weeks.

Result
She had exploratory laparotomy with the evacuation of the dead fetus and successful complete removal of the placenta. Her postoperative recovery was uneventful.

Conclusion
In view of the grave complications like a pelvic abscess, disseminated intravascular coagulation and bowel obstruction that may accompany retention of the placenta in advanced abdominal pregnancy, optimal placental removal at surgery is recommended whenever feasible.
- pregnancy,
- abdominal,
- ectopic,
- case reports
Citation: Victor Okey Dinwoke, Michael Oluchukwu Amara, Linda Uzo Amara. Abdominal pregnancy—a diagnosis never to miss[J]. AIMS Medical Science, 2022, 9(2): 342-347. doi: 10.3934/medsci.2022015

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Abstract

Background

Abdominal pregnancy is very rare, with only a few gynecologists being fortunate to encounter it all through their professional careers. It makes up only 1% of all ectopic pregnancies but has very high perinatal and maternal mortality of 95% and 18% respectively. Hemorrhagic and infectious complications account for these. Removal of the placenta at laparotomy is a big dilemma as torrential bleeding may ensue.

Case

We report the case of an undergraduate teenager who was referred with features of septicemia and anemia following unsafe vaginal instrumentation by a patent medicine dealer (a person without formal training in pharmacy but sells orthodox medications on retail basis) in a bid to terminate an extrauterine pregnancy. Ultrasonography confirmed a nonviable abdominal pregnancy of 20 weeks.

Result

She had exploratory laparotomy with the evacuation of the dead fetus and successful complete removal of the placenta. Her postoperative recovery was uneventful.

Conclusion

In view of the grave complications like a pelvic abscess, disseminated intravascular coagulation and bowel obstruction that may accompany retention of the placenta in advanced abdominal pregnancy, optimal placental removal at surgery is recommended whenever feasible.

Conflict of interest

The authors declare no conflict of interest.

References

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