Advanced abdominal pregnancy: case report and review of 163 cases reported since 1946.

Abstract

CONTEXT:

Though relatively rare, advanced abdominal pregnancy (AAP) can have dramatic and catastrophic consequences for the foetus and the mother. Difficult to diagnose pre-operatively, AAP presents special challenges to the physician working in remote areas with limited resources for diagnosis and management.

ISSUE:

CASE REPORT:

A case of AAP received in our hospital in Kolofata, Cameroon, is presented and followed by a review of 163 other cases reported from 13 countries since 1946.

LESSONS LEARNED:

A physician working in a remote district with an active maternity service should expect to encounter several cases of AAP during his or her working lifetime. Pre-operative diagnosis of AAP allows time for thoughtful preparation of the patient, family and medical team; however, to be diagnosed, AAP must first be considered. Diagnosis requires a high index of suspicion, and this should be triggered by any of a number of symptoms and signs reported in many cases of AAP. An unusual echographic appearance of the placenta was present in our case and prompted a more thorough investigation that confirmed the diagnosis. This finding has been reported by others and should be added to the list of signs and symptoms that might lead to a diagnosis of AAP in time to save the surgeon from an unpleasant and dangerous surprise.

• Authors: Daniel Nkusu Nunyalulendho, Ellen M Einterz
• Journal: Rural and remote health (Rural Remote Health) 2008 Oct-Dec Vol. 8 Issue 4 Pg. 1087 ISSN: 1445-6354 [Electronic] Australia
• PMID: 19053177 (Publication Type: Case Reports, Journal Article, Review)

Topics

• Adult
• Cameroon
• Female
• Humans
• Infant, Newborn
• Maternal Health Services
• Maternal Welfare
• Pregnancy
• Pregnancy Outcome
• Pregnancy, Abdominal (diagnosis, surgery)
• Rural Population