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

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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.

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Funding

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

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Post Graduate Institute of Medical Education and Research, Chandigarh, India

    Minakshi Rohilla, Bharti Joshi, Vanita Jain,  Neetimala & Shalini Gainder

  2. Chandigarh, India

    Bharti Joshi

Authors
  1. Minakshi Rohilla
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  2. Bharti Joshi
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  3. Vanita Jain
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  4. Neetimala
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  5. Shalini Gainder
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Contributions

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

Corresponding author

Correspondence to Bharti Joshi.

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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.

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Rohilla, M., Joshi, B., Jain, V. et al. Advanced abdominal pregnancy: a search for consensus. Review of literature along with case report. Arch Gynecol Obstet 298, 1–8 (2018). https://doi.org/10.1007/s00404-018-4743-3

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