TITLE:
Management Dilemma in Case of Abdominal Pregnancy: A Case Report
AUTHORS:
Alpana Singh, Vandana Mishra, Daisy Arun, Amita Suneja, Abha Sharma
KEYWORDS:
Secondary Abdominal Pregnancy, Cornual Rupture, Laparostomy Wound
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.4 No.14,
October
23,
2014
ABSTRACT: Introduction: Abdominal
pregnancy is a rare form of ectopic pregnancy demanding high index of suspicion
for diagnosis. We present a case of secondary abdominal pregnancy which was
missed at a peripheral centre and referred to us with laparostomy wound after
attempts were made to terminate it without proper diagnosis which resulted in
excessive bleeding. Case Presentation: A 30-year-old primigravida was referred
to us from a private clinic with a laparostomy wound. She had gone to the
private clinic for termination of her 5-month-old pregnancy. Medical method was
attempted initially failing which surgical evacuation was planned at second
visit which resulted in excessive bleeding. The patient was opened up, fetus
was removed from assumed uterine cavityand
attempted to remove the placenta caused torrential bleeding. The abdominal
cavity waspacked and she was
referred to a higher centre. Here she was taken up for re-exploration; ectopic
sac was separated from neighboring structures, right cornu was found ruptured
and was repaired. The patient also had wound dehiscence on post op day 7 for
which secondary abdominal closure was done. Conclusion: Secondary abdominal
pregnancy poses as a challenge to clinicians working in remote areas with
limited diagnostic facilities. The condition may be life threatening if not
handled meticulously.