Abdominal Pregnancy Before 20 Weeks: Management Difficulties in Limited-Access Areas

Abstract

Abstract

Background:

In current practice, abdominal pregnancy is rarely encountered. It seems to be more common in disadvantaged areas or in areas where there is insufficient prenatal follow-up for the population. Abdominal pregnancies are often encountered in advanced stages or at term. The resulting consequences are related to late diagnosis and high mortality and maternal–fetal morbidity. The types discovered early are classically terminated; however advanced cases comprise a topic of discussion.

Case:

A 35-year-old patient, primigravida, was being monitored in a secondary-level healthcare center. Her abdominal pregnancy was discovered by routine ultrasound (US) at 16 weeks, and close follow-up was planned. She was admitted to a hospital when the pregnancy reached 35 weeks for minimal bleeding, with no fetal movement and cardiac activity. The results of the US and computed tomography scanning showed oligohydramnios, a still fetus, in a transverse position, with overlapping bones of the skull. A laparotomy and an extraction of the fetus with the placenta as a whole were carried out with an uneventful follow-up period.

Results:

The postoperative events were simple and she had a postoperative hemoglobin level of 8 g/L. No complaints were noted during her follow-up.

Conclusions:

Prenatal follow-up by quality US is essential for early diagnosis of abdominal pregnancy. The prognosis of such pregnancies diagnosed early remains unpredictable, with reduced chances of success.