Secondary Abdominal Pregnancy Research Articles

A Report of Rare Case of Advanced Secondary Abdominal Pregnancy with Good Feto-Maternal Outcome Managed by Multidisciplinary Team

A Report of Rare Case of Advanced Secondary Abdominal Pregnancy with Good Feto-Maternal Outcome Managed by Multidisciplinary Team

Advanced secondary abdominal pregnancy: a case report

Background: Abdominal pregnancy, although a rare condition, has life-threatening consequences. This case report aims to expose the clinical and diagnostic challenges encountered in its management. We report a case of a 28-year-old gravida 2, para 1 woman, 35 weeks pregnant, who presented to Korle Bu Teaching Hospital with generalised abdominal pain and an ultrasound indicating a major-degree placenta previa. A repeat ultrasound assessment identified a viable abdominal pregnancy with the placenta attached to the uterine fundus. An emergency hysterectomy was done on account of a massive haemorrhage after the delivery of a live female foetus.

Secondary Abdominal Pregnancy at term: a case report

Abdominal pregnancy is a rare form of ectopic pregnancy and a serious form of extrauterine pregnancy. Abdominal pregnancy account for almost 1% of ectopic pregnancies. Rarely,it may reach at advanced gestation and a viable fetal outcome is a rare event. Sometimes, the diagnosis is suspected only when repeated attempts of induction of abortion or labor are unsuccessful. Really it is difficult to diagnose and manage. Here we are reporting a case of secondary abdominal pregnancy in a 27 years old primi gravida at 39+ weeks of gestation. It was observed from her ultrasonography that a single live pregnancy with breech presentation with almost absent liquor with IUGR baby then decision was made for lower uterine cesarean section under sub-arachnoid block. But it was turned into laparotomy and diagnosed as a secondary abdominal pregnancy. A healthy female baby was delivered. The placenta was attached with the omentum and large bowel loop. After tying and cutting the cord flushed with it's placental attachment, placenta was kept in situ. Abdomen was closed in layers. The diagnosis of abdominal pregnancy was made peroperatively with successful management and delivery of a healthy female baby.
 Bangabandhu Sheikh Mujib Med. Coll. J. 2022;1(2):104-106

Abdominal pregnancy secondary to uterine horn pregnancy: a case report

BackgroundPregnancy begins with a fertilized ovum that normally attaches to the uterine endometrium. However, an ectopic pregnancy can occur when a fertilized egg implants and grows outside the uterine cavity. Tubal ectopic pregnancy is the most common type (over 95%), with ovarian, abdominal, cervical, broad ligament, and uterine cornual pregnancy being less common. As more cases of ectopic pregnancy are diagnosed and treated in the early stages, the survival rate and fertility retention significantly improve. However, complications of abdominal pregnancy can sometimes be life-threatening and have severe consequences.Case presentationWe present a case of intraperitoneal ectopic pregnancy with fetal survival. Ultrasound and magnetic resonance imaging showed a right cornual pregnancy with a secondary abdominal pregnancy. In September 2021, we performed an emergency laparotomy, along with additional procedures such as transurethral ureteroscopy, double J-stent placement, abdominal fetal removal, placentectomy, repair of the right uterine horn, and pelvic adhesiolysis, in the 29th week of pregnancy. During laparotomy, we diagnosed abdominal pregnancy secondary to a rudimentary uterine horn. The mother and her baby were discharged eight days and 41 days, respectively, after surgery.ConclusionsAbdominal pregnancy is a rare condition. The variable nature of ectopic pregnancy can cause delays in timely diagnosis, resulting in increased morbidity and mortality, especially in areas with inadequate medical and social services. A high index of suspicion, coupled with appropriate imaging studies, can help facilitate its diagnosis in any suspected case.

ASSOCIATION OF SCAR TENDERNESS WITH SCAR INTEGRITY AT REPEAT CAESAREAN SECTION IN A TERTIARY CARE CENTRE: AN OBSERVATIONAL STUDY

BACKGROUND: Caesarean section is an operative process whereby the fetuses after the end of 28 th week are delivered through an incision on the abdominal and uterine wall .This excludes delivery through an abdominal incision where the fetus lying free in the abdominal cavity following uterine rupture or in secondary abdominal pregnancy .The rst operation carried out on a patient is referred to as primary caesarean section .When the operation is carried out in subsequent pregnancies , it is referred to as repeat caesarean section .Caesarean section is used in cases where vaginal delivery is not either feasible or would impose undue risk on mother or baby. AIMS&OBJECTIVE: METHODS: of the study to assess the relationship of scat tenderness with scar integrity at repeat caesarean section. It is a retrospective study, conducted in the admitted patients of Department of Obstetrics and Gynecology, Bundelkhand Medical College, Sagar Madhya Pradesh. The duration of the study from July 2022 to December 2022. During the study pe RESULTS: riod total 130 women were admitted with diagnosis of previous caesarean section with scar tenderness, out of these 88 (66%) had gestational age <37 weeks and on repeat caesarean section scar thinning present in 75(58%) cases. The scar complicat CONCLUSION: ions are highly associated with the intensity of scar tenderness .Hence forth, it can be concluded here that scat tenderness is a vital factor responsible for scar complications

Diagnostic and management dilemmas in secondary abdominal pregnancy: A case report and literature review of 314 cases from 1930-2021

Diagnostic and management dilemmas in secondary abdominal pregnancy: A case report and literature review of 314 cases from 1930-2021

Cases of full-term secondary abdominal pregnancy at the stage of mummification.

Recently, there have been more frequent reports of cases of late ectopic pregnancy. Less commonly, cases of full-term ectopic pregnancies are described, accounting for about 2% of all ectopic pregnancies. Even less common is a full-term ectopic pregnancy without rupture of the fetus, which, according to Rosenblat, is 0.23%.

A rare case of secondary abdominal pregnancy – case report and literature review

Abdominal pregnancy is a very rare form of ectopic preg­nan­cy and is associated with an increased mortality rate. The main life-threating complication is intraperitoneal ble­eding from placental site. The gestational age is im­por­tant for the prediction of complications’ severity. While most cases are secondary to a tubal rupture and the subsequently im­plan­ta­tion in the peritoneal cavity, a previous uterine per­fo­ra­tion can also represent the leading cause. In the current pa­per, we report an extremely rare case of secondary ab­do­mi­nal pregnancy with a gestational age of 11 weeks in a 37-year-old patient having a history of unnoticed ute­rine per­fo­ra­tion. This report raises awareness on a rare and se­vere obstetrical condition, discussing the case par­ti­cu­la­ri­ties, with the aim to highlight the urge for prompt diag­nos­tic and treatment measures.

Ectopic Pregnancy Diagnosed Post Caesarean Surgery in a Three Year Old Boerboel Bitch

Abstract A three year old nulliparous Boerboel bitch presented with complaints of fever and inappetence six weeks after an elective caesarean section was diagnosed with an extrauterine foetus. A per-cutaneous abdominal ultrasound revealed a foetal sac showing a well-developed skeletal structure and the absence of foetal movement or heartbeat. During laparotomy, a foetal sac containing a dead foetus was located between the spleen and the stomach. The foetal sac was excised following ligation of its mesenteric attachment to the spleen. The previously operated uterus was observed to have involuted but revealed a small bud observed on the middle portion of the left uterine horn. The histological findings of the foetal sac revealed fibro-adipose tissue with numerous congested vessels. It was concluded that the Boerboel bitch had a secondary abdominal ectopic pregnancy and recommended that owing to the difficulty of diagnosing the condition before or during routine elective caesarean surgery, post-operative abdominal ultrasound would have been instructive.

A case of secondary abdominal ectopic pregnancy in a bitch

AbstractCases of ectopic pregnancy (EP) and associated fetal mumification in bitches have been rarely reported. In this case report, it was aimed to present a case of secondary abdominal EP diagnosed in a 3‐year‐old bitch. Abdominal EP was incidentally diagnosed by radiographic examination of the bitch, which had a traffic accident, for likely possible fractures in the body. This case, which can be classified as secondary abdominal EP, was found to be compatible with the literature. The ectopic fetuses were removed from the body by surgical method, and the bitch was fully recovered.

A rare case report of advanced secondary abdominal pregnancy of 22 weeks during COVID 19 pandemic

A rare case report of advanced secondary abdominal pregnancy of 22 weeks during COVID 19 pandemic

Experience with ectopic pregnancies at the tertiary care center and lessons learnt

Introduction: Ectopic pregnancy is one of the life-threatening complications that can occur in any sexually active woman during reproductive age. Changing trends have been observed because of the availability of assisted reproductive techniques, better diagnostic facilities, conservative management approach, newer drugs for medical termination of pregnancy, and newer contraceptives. Materials and Methods: This was a cross-sectional study of all cases of ectopic pregnancy managed at the tertiary care center from January 2009 to December 2013. In all, there were 64 cases of ectopic pregnancies. Most of the women were between 20 and 30 years age and all except three were married. Risk factors could be identified in about 50% of women only. Results: The classical triad of amenorrhea, pain, and bleeding per vaginum was seen in 28.12% of subjects. Most of them were tubal ectopic pregnancies but we had one case of secondary abdominal pregnancy, two cases of heterotrophic pregnancy, one case of twin tubal pregnancy, and two cases of cornual pregnancy. All the cases were managed by laparotomy. An unsuccessful attempt to terminate a second-trimester pregnancy by the medical method should arouse suspicion of cornual pregnancy. Conclusion: History of use of levonorgestrel – emergency contraceptive pills should be looked for apart from other risk factors. Though not mandatory, ultrasonography should be done to rule out ectopic pregnancy, before terminating a pregnancy by the medical method.

Advancedsecondary Abdominal Pregnancy till Term: A Case Report

Introduction: Advanced abdominal pregnancy is a rare condition with high maternal & fetal morbidity as well as mortality. Inadequate placentation, unusual implantation &associated anomalies increase maternal &fetal morbidity and mortality. Diagnosis & management of advance abdominal pregnancy is always a challenge for obstetricians. Aims & Objectives: Management of rare case of advanced secondary abdominal pregnancy. Material & Methods: A 20yr young second gravida with full term gestation with history of previous L.S.C.S. with transverse lie & low lying placenta refered to our institute for emergency LSCS. Her last USG at 34wks showing single live intrauterine fetus in transverse lie with placenta previa. We avoided per vaginal examination in v/o central placenta previa. Decision of emergency L.S.C.S. was taken. After opening abdomen we got many surprises, after all obstacles we came out with successful outcome. Happily closed the abdomen with expression of victory. Results: With skillful and patient handling we were able to manage such a rare case with successful outcome in terms of mother as well as fetus even with complete removal of placenta. Conclusion: Advanced secondary abdominal pregnancy are rarely diagnosed clinically. Use of timely ultra sonography, intraoperative recognition, surgical skill, ready access to blood products, patiently taking decision about status of placenta are the cornerstone of successful management. Dreadful surprises can change in a remarkable unforgettable victory.

Term Broad Ligament Pregnancy with a Healthy Newborn

Introduction: Broad ligament pregnancy also known as inter ligamentous pregnancy is a rare type of ectopic pregnancy. It is one type of secondary abdominal pregnancy. Although ultrasonography is usually helpful in making the diagnosis but it is mostly established during laparotomy. Very few successful live births have been reported in this condition, where such pregnancies reached term and with live birth of a baby.
 Case Report: A case of 30 year old 2nd gravida of 38 weeks gestation with lower abdominal pain for 20 hours was admitted into Sher-E-Bangla Medical College Hospital, Barishal; Bangladesh. She was suggested for caesarean section as the ultrasonogram revealed transverse lie with complete placenta praevia. Intraoperative diagnosis of right sided broad ligament pregnancy was made and an incision was given on the anterior leaf of the broad ligament and a male live fetus was extracted. Post operative period was uneventful. Both mother and baby were discharged on seventh postoperative day in good health condition.
 Discussion: Broad ligament pregnancy usually results from rupture of tubal pregnancy through the tubal serosa and the mesosalpinx, with secondary implantation of trophoblast between the leaves of broad ligament. Incidence of broad ligament pregnancy is reported as 1 in 300 ectopic pregnancies. The prognosis is poor with the risk of dying from an abdominal pregnancy is 7.7 times higher than from other forms of ectopic pregnancy and often results from a delay in diagnosis. Trans-vaginal rather than transabdominal ultrasonography is superior in the evaluation of ectopic pregnancy. If there is no intrauterine pregnancy on ultrasonography and the ectopic sac is beside the lower part of the uterus a strong suspicion of broad ligament ectopic should be considered. Very rarely such pregnancy may reach up to term. Bleeding from placental implantation site is the most life-threatening complication during laparotomy.
 Conclusion: Abdominal pregnancy with resultant healthy newborn is very rare. High level of suspicion, careful clinical and ultrasound examinations are the routine means of diagnosis. Bleeding is the single most important life-threatening complication for the mother. Early diagnosis and proper management are vital in order to decrease maternal morbidity.
 Medicine Today 2019 Vol.31(1): 60-63

A Review: Obstetrical Emergencies in Small Ruminants

Obstetrical emergencies are common in small ruminants and requires immediate intervention to prevent the mortality associated with it. The activation of the hypothalamic-pituitary-adrenal function of fetus is initial step in the parturition process in the small ruminants. Dystocia is the most common obstetrical emergency of small ruminants, which can occur due to either maternal or fetal causes. Ring womb/incomplete cervical dilation was found to be the most common maternal cause resulting in dystocia. Among the fetal causes of dystocia, fetal maldisposition was found to the prominent cause. Different authors report several unusual cases of dystocia. This included rare conditions like congenital polycystic kidney disease, fetal ascites, facial dysmorphism, rhabdomyoma, arthrogryposis, hydrallantois, fetal goitre, uterine adhesion, secondary abdominal pregnancy, ventral abdominal hysterocele, and prepubic tendon rupture. Thus, the objectives of this review are to identify and analyse the common and rare obstetrical emergencies of small ruminants. This review also describes guidelines for diagnosing and managing such obstetrical emergencies.

Ectopic Pregnancy in Two Cats

Background: Ectopic pregnancy mainly refers to tubal pregnancy and abdominal pregnancy. Tubal pregnancy presents as an implanted embryo that develops in the fallopian tubes, and is relatively common in humans. In animals, tubal pregnancy occurs primarily in primates, for example monkeys. The probability of a tubal pregnancy in non-primate animals is extremely low. Abdominal pregnancy is a type of ectopic pregnancy that occurs outside of the uterus, fallopian tube, ovary, and ligament(broad ligament, ovarian ligament, suspensory ligament).This paper describes two cases of ectopic pregnancy in cats.Cases: Cat 1. The presenting sign was a significant increase in abdominal circumference. The age and immune and sterilization status of the cat were unknown. On palpation, a 4 cm, rough, oval-shaped, hard mass was found in the posterior abdomen. Radiographic examination showed three high-density images in the posterior abdomen. The fetus was significantlycalcified and some feces was evident in the colon. The condition was preliminarily diagnosed as ectopic pregnancy. Cat 2. The owner of a 2-year-old British shorthair cat visited us because of a hard lump in the cat’s abdomen. The cat had a normal diet and was drinking normally. Routine immunization and insect repulsion had been implemented. The cat had naturally delivered five healthy kittens two months previous. Radiographs showed an oval-shaped mass with a clear edge in the middle abdominal cavity. Other examinations were normal. The case was preliminarily diagnosed as ectopic pregnancy, and the pregnancy was surgically terminated. The ectopic pregnancies were surgically terminated. During surgery, the structures of the uterus and ovary of cat 1 were found to be intact and the organs were in a normal physiological position.Cat 1 was diagnosed with primary abdominal pregnancy. In cat 2, the uterus left side was small and the fallopian tube on the same side was both enlarged and longer than normal. Immature fetuses were found in the gestational sac. Thus, cat 2 was diagnosed with tubal ectopic pregnancy based on the presenting pathology.Discussion: Cats with ectopic pregnancies generally show no obvious clinical symptoms. The ectopic fetus can remain within the body for several months or even years. Occasionally, necrotic ectopic tissues or mechanical stimulation of the ectopic fetus can lead to a systemic inflammatory response, loss of appetite, and apathy. The two cats in our reportshowed no significant clinical symptoms. To our knowledge, there have been no previous reports of the development of an ectopic fetus to maturity, within the abdominal cavity of felines, because the placenta of cats cannot support the growth and development of the fetus outside of the uterus. Secondary abdominal ectopic pregnancy, lacking any signs of uterine rupture is likely associated with the strong regenerative ability of uterine muscles. A damaged uterus or fallopian tube can quickly recover and rarely leaves scar tissue. In the present report, cat 1 showed no apparent scar tissue, nor signs of a ruptured ovary or fallopian tubes. It was diagnosed with primary ectopic abdominal pregnancy, which could arise from the descent of the fertilized egg from the fallopian tube into the abdominal cavity. There was an abnormal protrusion in left of the fallopian tubes in cat 2, to which the gestational sac was directly connected. Based on pathological examination of the uterus, fallopian tubes, and gestational sac, the cat was diagnosed with a tubal pregnancy. Placental tissues and signs of fetal calcification were observed in both the fallopian tube and gestational sac.Keywords: tubal pregnancy, abdominal pregnancy, feline, ectopic fetus, fallopian tube, gestational sac.

Successful Management of Abdominal Pregnancy: Two Case Reports

Abdominal pregnancy is a rare, life-threatening condition defined as pregnancy in the peritoneal cavity exclusive of tubal, ovarian, or intraligamentary locations. It can be primarily located in the peritoneal cavity or secondary to a ruptured ectopic pregnancy or tubal abortion. We present two cases of abdominal pregnancy, one primary and another secondary, both diagnosed and successfully managed in our institution. The first patient, a para 2 at 14 weeks gestation, presented with abdominal pain, distension, and dizziness, which had started four days prior. The initial radiological scan reported an intrauterine pregnancy with ascites, but a bedside ultrasound revealed an empty uterus and a viable pregnancy located in the Pouch of Douglas (POD). This was a secondary abdominal pregnancy managed successfully by laparotomy. The second patient, a para 3 + 4 miscarriages with seven weeks amenorrhea was admitted with an initial diagnosis of pregnancy of unknown location. She had a beta human chorionic gonadotropin level of 14 444 mIU/mL. Diagnostic laparoscopy revealed a hemoperitoneum, bulky uterus, normal looking right and left adnexa, and a dense irregular bleeding tissue of around 3 × 4 cm firmly attached to the POD. The histopathology report of the tissue retrieved from the POD confirmed products of conception. This case report supports the importance of awareness and high clinical suspicion for such a life-threatening condition to avoid maternal morbidity and mortality. To the best of our knowledge, no previous cases of abdominal pregnancy have been reported in the UAE to date.

Secondary Abdominal Pregnancy – A Case Report

Secondary Abdominal Pregnancy – A Case Report

A case of secondary abdominal pregnancy following intrauterine device incarceration

A case of secondary abdominal pregnancy following intrauterine device incarceration

Embarazo ectópico abdominal secundario a perforación uterina por interrupción voluntaria del embarazo: presentación de caso

Secondary abdominal ectopic pregnancy is rare in clinical practice, but may lead to an increased maternal mortality. We present the case of a patient with an abdominal pregnancy secondary to a uterine perforation caused by a voluntary attempt to interrupt pregnancy that presented with nine weeks of abdominal pain and minimal vaginal bleeding which was mistakenly diagnosed as acute pelvic inflammatory disease, urinary tract infection, and post-abortion products of conception. Finally, the abdominal ultrasound test found an abdominal ectopic pregnancy. An exploratory laparotomy was performed and the fetus and placenta were removed without difficulties with a favorable postoperative course. It was concluded that uterine perforation during curettage of the cavity went unnoticed, leading to secondary abdominal implantation of pregnancy with a inconclusive clinical presentation, where ultrasound plays a fundamental diagnostic role. Laparotomy is indicated in most of these cases.