Abdominal pregnancy in early and late gestation
Belokrinitskaya T.E., Frolova N.I., Kustova A.A., Nikolaeva E.Yu., Zolotukhina А.О., Barkan T.M., Byshina N.N.
Background: Abdominal pregnancy is a rare form of ectopic pregnancy characterized by an increased risk of serious obstetric complications, maternal morbidity and mortality, neonatal morbidity and perinatal loss. Despite the use of modern imaging techniques in prenatal diagnosis, detection of abdominal pregnancy remains a difficult task and in most cases the pathology is not diagnosed before surgical intervention.
Case report: The paper presents two clinical cases of abdominal pregnancy that were observed in the same period of time. In the first case, laparotomy was performed at 34 weeks gestation for abdominal pain in a multiparous patient with placenta increta (PAS Grade 2) and progressive oligohydramnios; abdominal pregnancy was detected intraoperatively. A live infant without developmental anomalies was born. Hysterectomy was performed due to the attachment of the placenta into the uterine wall (PAS Grade 2), blood loss was 3000 ml. In the second case, abdominal pregnancy was also localized on the uterus, but the pregnancy was terminated early and the diagnosis was made only during emergency laparoscopy; blood loss was about 1000 ml.
Conclusion: According to the current literature, most cases of abdominal pregnancy are diagnosed intraoperatively. Lack of a standardized diagnostic algorithm is its contributing factor. The detection of abdominal pregnancy (especially in late gestation) during surgery is associated with technical and tactical difficulties for obstetricians and gynecologists, the need for emergency involvement of doctors of different surgical specialties and transfusion medicine specialists. The classification of reported cases of abdominal pregnancy in late gestation and their systematic analysis may help to standardize approaches to diagnosis and treatment, and reduce the risk of complications for both mother and fetus.
Authors’ contributions: Belokrinitskaya T.E. – developing the concept and design of the study, supervision, collection and analysis of publications on the subject of the article, writing and editing the text; Frolova N.I. – collection and analysis of publications on the subject of the article, writing the text; Kustova A.A., Nikolaeva E.Yu., Barkan T.M., Byshina N.N. – collecting and processing clinical material; Zolotukhina A.O. – pathomorphological studies, preparation of photographs of placenta micro specimens, their description.
Conflicts of interest: Authors declare lack of the possible conflicts of interest.
Funding: The study was carried out without sponsorship.
Patient Consent for Publication: The patients provided an informed consent for the publication of their data and associated images.
For citation: Belokrinitskaya T.E., Frolova N.I., Kustova A.A., Nikolaeva E.Yu., Zolotukhina А.О.,
Barkan T.M., Byshina N.N. Abdominal pregnancy in early and late gestation.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2025; (5): 186-194 (in Russian)
https://dx.doi.org/10.18565/aig.2025.18
Keywords
abdominal pregnancy
early abdominal pregnancy
abdominal pregnancy of the third trimester
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Received 28.01.2025
Accepted 05.05.2025
About the Authors
Tatiana E. Belokrinitskaya, Dr. Med. Sci., Professor, Head of the Obstetrics and Gynecology Department of the Pediatric Faculty and Faculty of Professional Retraining,Chita State Medical Academy, Ministry of Health of Russia, 672000, Russia, Chita, Gorky str., 39a, +7(3022)32-30-58, tanbell24@mail.ru,
https://orcid.org/0000-0002-5447-4223
Nataly I. Frolova, Dr. Med. Sci., Associate Professor at the Department of Obstetrics and Gynecology of the Pediatric Faculty and Faculty of Professional Retraining,
Chita State Medical Academy, Ministry of Health of Russia, 672000, Russia, Chita, Gorky str., 39a, taasyaa@mail.ru, https://orcid.org/0000-0002-7433-6012
Anna A. Kustova, obstetrician-gynaecologist, Head of the Pregnancy Pathology Department, Perinatal Center of Transbaikal Regional Hospital, 672038, Russia, Chita,
Kohansky str., 5, kustovaanna911@mail.ru, https://orcid.org/0000-0002-1636-6440
Ekaterina Yu. Nikolaeva, obstetrician-gynaecologist of the Pregnancy Pathology Department, Perinatal Center of Transbaikal Regional Hospital,
672038, Russia, Chita, Kohansky str., 5, nickola.ekaterina@yandex.ru
Anastasiya O. Zolotukhina, Head of the Department of Pediatric and Prenatal Pathology, Transbaikal Regional Pathology Bureau, 672038, Russia, Chita, Matveeva str., 64, zolot-anastasiya@mail.ru, https://orcid.org/0000-0002-1136-1798
Tatiana M. Barkan, оbstetrician-gynaecologist, Head of the Gynecology Department, Clinical Hospital RZD-Medicine, 672000, Russia, Chita, Lenin str., 4,
tat.barkan@yandex.ru, https://orcid.org/0009-0006-0805-1648
Natalia N. Byshina, оbstetrician-gynaecologist of the Gynecology Department, Clinical Hospital RZD-Medicine, 672000, Russia, Chita, Lenin str., 4, nataliabyshina82@mail.ru, https://orcid.org/0009-0002-8606-4058
Corresponding author: Tatiana E. Belokrinitskaya, tanbell24@mail.ru
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