Advertisement

Archives of Gynecology and Obstetrics

, Volume 298, Issue 1, pp 1–8 | Cite as

Advanced abdominal pregnancy: a search for consensus. Review of literature along with case report

  • Minakshi Rohilla
  • Bharti Joshi
  • Vanita Jain
  • Neetimala
  • Shalini Gainder
Review
  • 138 Downloads

Abstract

Background

Advanced abdominal pregnancy is a highly morbid form of extrauterine gestation that demands skilled management. Despite advancement in antenatal care and imaging modalities, undiagnosed cases of advanced abdominal pregnancies are still reported. We report a case of asymptomatic abdominal pregnancy with healthy fetus advanced till 40 + 4 weeks period of gestation. Her diagnosis was not established even after obstetrical evaluation and cesarean section at primary care hospital. To the best of our knowledge, less than 10 postdated cases of abdominal pregnancy have been reported so far in the literature. This case emphasizes the need to re-awaken awareness and high index of suspicion to diagnose such cases. Details of all the cases pertaining to advanced abdominal pregnancies reported after 2013 were reviewed and summarized.

Methodology

We searched electronic medical database in English using keywords related to abdominal pregnancy. Bibliographies of the relevant articles of advanced abdominal pregnancy published from 2013 onwards were reviewed and then cross searched to identify further relevant studies.

Results

A total of 26 cases of advanced abdominal pregnancy including index one were reviewed. All preoperatively diagnosed cases of abdominal pregnancy at earlier gestation were given conservative management and resulted in live births. The incidence of malformations in live births was 24%.

Conclusion

We are of considered opinion that conservative strategy is a feasible option in selected cases of advanced abdominal pregnancy yet there is a need of standardization of treatment principles for such cases to optimize fetomaternal outcome.

Keywords

Advanced abdominal pregnancy Placenta Complications Ectopic pregnancy 

Notes

Author contributions

MR patient management and editing. BJ data collection and manuscript writing. VJ patient management. NM data collection. SG patient management.

Funding

There is no funding issues as this is a case study along with review.

Compliance with ethical standards

Conflict of interest

Authors declare that there is no conflict of interest.

Statement of human rights

As this was a case study and involved patient management as per institutional protocol. There is no additional interventional procedure done in this case. This article does not contain any human participants performed by any of the authors.

Comment on ethics

As this article is a review of literature along with case study, ethical clearance obtained from the departmental committee of obstetrics and gynaecology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.

Informed consent

Informed consent was taken from the patient regarding publication of the index article which will be produced if required.

References

  1. 1.
    Nwobodo EI (2004) Abdominal pregnancy. A case report. Ann Afr Med 3(4):195–196Google Scholar
  2. 2.
    Badria L, Amarin Z, Jaradat A, Zahawi H, Gharaibeh A (2003) Full-term viable abdominal pregnancy. A case report and review. Arch Gynaecol Obstet 268(4):340–342CrossRefGoogle Scholar
  3. 3.
    Dover RW, Powell MC (1995) Management of a primary abdominal pregnancy. Am J Obstet Gynecol 172:1603–1604CrossRefPubMedGoogle Scholar
  4. 4.
    Varma R, Mascarenhas R, Jame D (2003) Successful outcome of advanced abdominal pregnancy with exclusive omental insertion. Ultrasound Obstet Gynecol 21:192–194CrossRefPubMedGoogle Scholar
  5. 5.
    Masukume G (2014) Live births resulting from advanced abdominal extrauterine pregnancy, a review of cases reported from 2008 to 2013. Webmed Cent Obstet Gynaecol 5(1):wmc004510Google Scholar
  6. 6.
    Rahaman J, Berkowitz R, Mitty H, Gaddipati S, Brown B, Nezhat F (2004) Minimally invasive management of advanced abdominal pregnancy. Obstet Gynecol 103:1064–1068CrossRefPubMedGoogle Scholar
  7. 7.
    Sharma R, Puri M, Madan M, Trivedi SS (2012) Advanced live intra-abdominal pregnancy with good fetomaternal outcome: a case report. Int J Case Rep Images 3(11):5–8Google Scholar
  8. 8.
    Kassam M (2007) Abdominal pain in pregnancy. In: David KJ, Philips JS, Carl PW, Bernard G (eds) High risk pregnancy: management option. WB Saunders, London, pp 996–997Google Scholar
  9. 9.
    Nkusu Nunyalulndho D, Eintrerz EM (2008) Advanced abdominal pregnancy: case report and review of 163 cases reported since 1946. Rural Remote Health 8(4):1087Google Scholar
  10. 10.
    Sunday-Adeoye I, Twomey D, Egwuatu EV, Okonta PI (2011) A 30-year review of advanced abdominal pregnancy at the Mater Misericordiae Hospital, Afikpo, southeastern Nigeria (1976–2006). Arch Gynecol Obstet 283:19–24CrossRefPubMedGoogle Scholar
  11. 11.
    Amritha B, Sumangali T, Priya B, Deepak S, Rai S (2009) A rare case of term viable secondary abdominal pregnancy following rupture of a rudimentary horn. A case report. J Med Case Rep 3:38CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Atrash HK, Friede A, Hogue CJR (1987) Abdominal pregnancy in the United States: frequency and maternal mortality. Obstet Gynaecol 69:333–337Google Scholar
  13. 13.
    Cross JB, Lester WM, McCain JR (1951) The diagnosis and management of abdominal pregnancy with a review of 19 cases. Am J Obstet Gynecol 62:303–311CrossRefPubMedGoogle Scholar
  14. 14.
    Aydogdu M, Heilmann I, Schutte P, Trams G (2001) Advanced ectopic pregnancy-clinical management. Zentralbl Gynakol 123:585–587CrossRefPubMedGoogle Scholar
  15. 15.
    Lockhat F, Corr P, Ramphal S, Moodley J (2006) The value of magnetic resonance imaging in the diagnosis and management of extra-uterine abdominal pregnancy. Clin Radiol 61:269CrossRefGoogle Scholar
  16. 16.
    Karat LS (2007) Viable abdominal pregnancy. J Obstet Gynecol India 57(2):169–170Google Scholar
  17. 17.
    Marcellin L, Ménard S, Lamau MC, Mignon A, Aubelle MS, Grangé G, Goffinet F (2014) Conservative management of an advanced abdominal pregnancy at 22 weeks. AJP Rep 4(1):55–60CrossRefPubMedPubMedCentralGoogle Scholar
  18. 18.
    Beddock R, Naepels P, Gondry C et al (2004) Diagnosis and current concepts of management of advanced abdominal pregnancy. Gynecol Obstet Fertil 32(1):55–61CrossRefPubMedGoogle Scholar
  19. 19.
    Martin JN Jr, McCaul JFIV (1990) Emergent management of abdominal pregnancy. Clin Obstet Gynecol 33(3):438–447CrossRefPubMedGoogle Scholar
  20. 20.
    Cardosi RJ, Nackley AC, Londono J, Hoffman M (2002) Embolization for advanced abdominal pregnancy. J Reprod Med 47(10):861–863PubMedGoogle Scholar
  21. 21.
    Eneli AC, Kuku SB (1975) Advanced abdominal pregnancy: two case reports. Nig Med J 5:170–171Google Scholar
  22. 22.
    Pradhan M, Sreenivas M, Singh B, Behera C, Dikshit PC (2013) Sudden death in advanced abdominal pregnancy: a case report and discussion of the related medicolegal issues. Med Sci Law 53:90–92CrossRefPubMedGoogle Scholar
  23. 23.
    Mpogoro FJ, Gumodoka B, Kihunrwa A, Massinde AN (2013) Managing a live advanced abdominal twin pregnancy. Ann Med Health Sci Res 3(1):113–115CrossRefPubMedPubMedCentralGoogle Scholar
  24. 24.
    Matovelo D, Ng’walida N (2014) Hemoperitoneum in advanced abdominal pregnancy with a live baby: a case report. BMC Res Notes 7:106CrossRefPubMedPubMedCentralGoogle Scholar
  25. 25.
    Fouelifack FY, Fouogue JT, Fouedjio JH, Sando Z (2014) Viable abdominal pregnancy: a case report in Yaoundé (Cameroon). Pan Afr Med J 18:181PubMedPubMedCentralGoogle Scholar
  26. 26.
    Ahirwar N, Shukla P, Natung P (2014) Full term extrauterine abdominal pregnancy. J Evol Med Dent Sci 3(8):1895–1899CrossRefGoogle Scholar
  27. 27.
    Huang K, Song L, Wang L, Gao Z, Meng Y, Lu Y (2014) Advanced abdominal pregnancy: an increasingly challenging clinical concern for obstetricians. Int J Clin Exp Pathol 7(9):5461–5472PubMedPubMedCentralGoogle Scholar
  28. 28.
    Joshi B, Aggarwal N, Singh A (2014) Obstetrical catastrophe averted: successful outcome of an abdominal pregnancy. Am J Emerg Med 32:1299.e3–1299.e4CrossRefGoogle Scholar
  29. 29.
    Bohiltea R, Radoi V, Tufan C, Horhoianu IA, Bohiltea C (2015) Abdominal pregnancy—case presentation. J Med Life 8(1):49–54PubMedPubMedCentralGoogle Scholar
  30. 30.
    Mengistu Z, Getachew A, Adefris M (2015) Term abdominal pregnancy: a case reports. J Med Case Rep 9:168CrossRefPubMedPubMedCentralGoogle Scholar
  31. 31.
    Gudu W, Bekele D (2015) A pre-operatively diagnosed advanced abdominal pregnancy with a surviving neonate: a case report. J Med Case Rep 9:228CrossRefPubMedPubMedCentralGoogle Scholar
  32. 32.
    Gélvez-Téllez S (2015) Advanced abdominal pregnancy with a live foetus. Case report and review of the literature. Revista Colombiana de Obstetricia y Ginecología 66(1):61–66CrossRefGoogle Scholar
  33. 33.
    Anozie OB, Esike CUO, Eze JN, Oga EO, Nwali MI, Otti KO (2016) Advanced abdominal ectopic pregnancy: a case report. Open J Obstet Gynecol 6:360–364CrossRefGoogle Scholar
  34. 34.
    El-Agwany AS, El-badawy ES, El-habashy A, El-gammal H, Abdelnaby M (2016) Secondary advanced abdominal pregnancy after suspected ruptured cornual pregnancy with good maternal outcome: a case with unusual gangrenous fetal toes and ultrasound diagnoses managed by hysterectomy. Clin Med Insights Women’s Health 9:CMWH-S36311CrossRefGoogle Scholar
  35. 35.
    Aliyu I, Ashimi A (2016) Hydrocephalic newborn in a missed advanced abdominal pregnancy-diagnostic challenges in a rural setting: a case report. J Mahatma Gandhi Inst Med Sci 21:46–49CrossRefGoogle Scholar
  36. 36.
    Giwa-Osagie O, Ekaidem B, Kayode B, Are B, Aisagbohni P, Oniha C (2016) Advanced abdominal pregnancy following in vitro fertilization and embryo transfer: a case report. J Gynecol Obstet 4(1):1–6CrossRefGoogle Scholar
  37. 37.
    Harirah HM, Smith JM, Dixon CL, Hankins GD (2016) Conservative management and planned surgery for periviable advanced extrauterine abdominal pregnancy with favorable outcome: report of two cases. Am J Perinatol Rep 6:e301–e308CrossRefGoogle Scholar
  38. 38.
    Trivedi K, Singh L (2016) Advanced abdominal pregnancy with a healthy newborn: a rare case report. Int J Reprod Contracept Obstet Gynecol 5:3583–3586CrossRefGoogle Scholar
  39. 39.
    Udigwe GO, Eleje GU, Ihekwoaba EC, Udegbunam OI, Egeonu RO, Okwuosa AO (2016) Acute intestinal obstruction complicating abdominal pregnancy: conservative management and successful outcome. Case Rep Obstet Gynecol 2016:2576280.  https://doi.org/10.1155/2016/2576280 PubMedPubMedCentralCrossRefGoogle Scholar
  40. 40.
    Nassali MN, Benti TM, Bandani-Ntsabele M, Musinguzi E (2016) A case report of an asymptomatic late term abdominal pregnancy with a live birth at 41 weeks of gestation. BMC Res Notes 9:31CrossRefPubMedPubMedCentralGoogle Scholar
  41. 41.
    Sharma S, Gehlot H, Sharma DD, Choudhary S (2016) A term live advanced abdominal pregnancy: a rare case report. Int J Reprod Contracept Obstet Gynecol 5(4):1233–1236CrossRefGoogle Scholar
  42. 42.
    Abdelrahman S, Deeter M, Muthusami A, Peterson TG, Wackenier L (2017) A live term intra-abdominal pregnancy in a Field Hospital: a case report. J Surg Case Rep 3:1–2CrossRefGoogle Scholar
  43. 43.
    Abdullahi HM, Yakasai IA, Zakari M, Shuaibu SD (2013) Late presentation of advanced abdominal pregnancy with live baby: a case report and literature review. Niger J Basic Clin Sci 10:25–28CrossRefGoogle Scholar
  44. 44.
    Tolfac PN, Abanda MH, Minkande JZ, Priso EB (2017) The challenge in the diagnosis and management of an advanced abdominal pregnancy in low resource settings: a case report. J Med Case Rep 11(1):199CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Obstetrics and GynecologyPost Graduate Institute of Medical Education and ResearchChandigarhIndia
  2. 2.ChandigarhIndia

Personalised recommendations