Delivery after advanced abdominal pregnancy
Background: Abdominal pregnancy is a rare type of ectopic pregnancy with poor maternal and fetal outcomes. A unified strategy to manage patients with abdominal pregnancy has not presently been developed in relation to the timing and methods of delivery.Efremov P.I., Efremov A.P., Kryukov V.A., Bondarevsky I.Ya., Sherstobitov A.V., Fortygin A.Ya., Fortygina Yu.A., Shmakov R.G.
Case report: The paper describes a clinical case of term abdominal pregnancy with a favorable outcome for the mother and fetus. It depicts the features of delivery and postoperative patient management strategy. The applied integrated approach has allowed not only delivery without risks to the mother and fetus, but also led to the elaboration of a new approach to postoperative management.
Conclusion: This clinical case demonstrates the need for an individual approach to choosing the terms and methods of delivery on the basis of the data of instrumental studies. This approach contributes to the choice of the optimal strategy of pregnancy management, delivery, and newborn care.
Keywords
abdominal pregnancy
ectopic pregnancy
extrauterine pregnancy
References
- Al Naimi A., Moore P., Brüggmann D., Krysa L., Louwen F., Bahlmann F. Ectopic pregnancy: a single-center experience over ten years. Reprod. Biol. Endocrinol. 2021; 19(1): 79. https://dx.doi.org/10.1186/s12958-021-00761-w.
- Bellver J. Female underweight and risk of ectopic pregnancy. BJOG. 2021; 128(3): 551. https://dx.doi.org/10.1111/1471-0528.16418.
- Shabbir U., Anwar J., Asghar M.S., Zaman B.S., Afzal A., Nadeem M. A ruptured seventeen weeks' ectopic pregnancy: a case report. J. Pak. Med. Assoc. 2021; 71(2(B)): 763-5. https://dx.doi.org/10.47391/JPMA.10-1181.
- Nash C., Fortuna T., Schollenberg E., Rittenberg D. A 20-week cornual ectopic pregnancy. J. Obstet. Gynaecol. Can. 2020; 42(12): 1455.https://dx.doi.org/10.1016/j.jogc.2019.06.003.
- Fessehaye A., Gashawbeza B., Daba M., Arusi M., Terefe T. Abdominal ectopic pregnancy complicated with a large bowel injury: a case report. J. Med. Case Rep. 2021; 15(1): 127. https://dx.doi.org/10.1186/s13256-021-02713-9.
- Antequera A., Babar Z., Balachandar C., Johal K., Sapundjieski M., Qandil N. Managing ruptured splenic ectopic pregnancy without splenectomy: case report and literature review. Reprod. Sci. 2021; 28(8): 2323-30.https://dx.doi.org/10.1007/s43032-021-00476-8.
- Лялина Е.А., Керимкулова Н.В., Ратманов М.А. Нарушенная первичная брюшная беременность. Вестник Ивановской медицинской академии. 2009; 14(3): 38-40. [Lyalina E.A., Kerimkulova N.V., Ratmanov M.A. Incomplete primary abdominal pregnancy. Bulletin of the Ivanovo Medical Academy. 2009; 14(3): 38-40. (in Russian)].
- Chughtai F. Twin abdominal pregnancy – a rare scenario. J. Pak. Med. Assoc. 2017; 67(5): 793-5.
- Goldman G.A., Dicker D., Ovadia J. Primary abdominal pregnancy: can artificial abortion, endometriosis and IUD be etiological factors? Eur. J. Obstet. Gynecol. Reprod. Biol. 1988; 27(2): 139-43. https://dx.doi.org/10.1016/0028-2243(88)90007-x.
- Rohilla M., Joshi B., Jain V., Neetimala, Gainder S. Advanced abdominal pregnancy: a search for consensus. Review of literature along with case report. Arch. Gynecol. Obstet. 2018; 298(1): 1-8. https://dx.doi.org/10.1007/s00404-018-4743-3.
- National Institute for Health and Care Excellence: Guidelines. Ectopic pregnancy and miscarriage: diagnosis and initial management. London: National Institute for Health and Care Excellence (NICE); 2021 Nov 24.
- Strafford J.C., Ragan W.D. Abdominal pregnancy. Review of current management. Obstet. Gynecol. 1977; 50(5): 548-52.
- Tait R. Lectures on ectopic pregnancy and pelvic haematocele. Birmingham, England; 1889. 107p.
- Sib S.R., Ouédraogo I., Sanogo M., Kiemtoré S., Sawadogo Y.A., Zamané H.et al. A full term abdominal pregnancy with an isthmic tubal implantation of the placenta. BMC Pregnancy Childbirth. 2018; 18(1): 448.https://dx.doi.org/10.1186/s12884-018-2071-z.
- Zhang J., Li F., Sheng Q. Full-term abdominal pregnancy: a case report and review of the literature. Gynecol. Obstet. Invest. 2008; 65(2): 139-41.https://dx.doi.org/10.1159/000110015.
- Hailu F.G., Yihunie G.T., Essa A.A., Tsega W.K. Advanced abdominal pregnancy, with live fetus and severe preeclampsia, case report. BMC Pregnancy Childbirth. https://dx.doi.org/10.1186/s12884-017-1437-y.
- Attapattu J.A.F., Menon S. Abdominal pregnancy. Int. J. Gynecol. Obstet. 1993; 43(1): 51-5. https://dx.doi.org/10.1016/0020-7292(93)90274-z.
- Nunyalulendho D.N., Einterz E.M. Advanced abdominal pregnancy: case report and review of 163 cases reported since 1946. Rural Remote Health.2008; 8(4): 1087.
- Mengistu Z., Getachew A., Adefris M. Term abdominal pregnancy: A case report. J. Med. Case Rep. 2015; 9: 168. https://dx.doi.org/10.1186/s13256-015-0635-3.
- George R., Powers E., Gunby R. Abdominal ectopic pregnancy. Proc. (Bayl. Univ. Med. Cent.). 2021; 34(4): 530-1. https://dx.doi.org/10.1080/08998280.2021.1884932.
- Baffoe P., Fofie C., Gandau B.N. Term abdominal pregnancy with healthy newborn: a case report. Ghana Med. J. 2011; 45(2): 81-3. https://dx.doi.org/10.4314/gmj.v45i2.68933.
- Abdelrahman S., Deeter M., Muthusami A., Peterson T.G., Wackenier L. A live term intra-abdominal pregnancy in a field hospital: a case report. J. Surg. Case Rep. 2017; 2017(3): rjx062. https://dx.doi.org/10.1093/jscr/rjx062.
- Siati A., Berrada T., Baidada A., Kharbach A. Abdominal pregnancy with a healthy newborn: a new case. Pan. Afr. Med. J. 2019; 34: 35.https://dx.doi.org/10.11604/pamj.2019.34.35.20169.
Received 21.04.2022
Accepted 06.05.2022
About the Authors
Pavel I. Efremov, Honored Doctor of the Russian Federation, doctor of highest category, Head of the Department of Gynecology, Chelyabinsk Regional Clinical Hospital, +7(912)893-50-83, chel-ginekology@yandex.ru, 454048, Russia, Chelyabinsk, Vorovskogo str., 70.Anton P. Efremov, doctor of highest category, Head of the Department of Endoscopic Surgery, Chelyabinsk Regional Clinical Hospital, +7(922)230-65-18,
aefremov78@mail.ru, 454048, Russia, Chelyabinsk, Vorovskogo str., 70.
Vladimir A. Kryukov, doctor at the Department of Gynecology, Chelyabinsk Regional Clinical Hospital, +7(919)303-39-68, Vladimir_kryukov@outlook.com,
454048, Russia, Chelyabinsk, Vorovskogo str., 70.
Ilya Ya. Bondarevsky, Dr. Med. Sci., Chief Surgeon of the Ministry of Health of the Chelyabinsk Region, doctor of highest category, Deputy Chief Physician for Medical Surgery, Chelyabinsk Regional Clinical Hospital, +7(908)067-96-07, bond_il@mail.ru, 454048, Russia, Chelyabinsk, Vorovskogo str., 70.
Aleksey V. Sherstobitov, Chief Obstetrician-gynecologist of the Ministry of Health of the Chelyabinsk Region, Deputy Chief Physician for Obstetrics, Head of the Maternity Department, doctor of highest category, Regional Perinatal Center, +7(902)897-20-53, arno1980@yandex.com, 454076, Russia, Chelyabinsk, Vorovskogo str., 70 build. 12.
Aleksey Ya. Fortygin, Honored Doctor of the Russian Federation, doctor of highest category, Deputy Chief Physician for Gynecology and Surgery, Regional Perinatal Center, +7(902)892-49-72, le.fort@mail.ru, 454076, Russia, Chelyabinsk, Vorovskogo str., 70 build. 12.
Yuliya A. Fortygina, postgraduate student, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, +7(950)727-07-45, yu_fortygina@oparina4.ru, 117997, Russia, Moscow, Academician Oparin str., 4.
Roman G. Shmakov, Dr. Med. Sci., Professor of the Russian Academy of Sciences, Director of the Institute of Obstetrics, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, +7(495)438-72-00, r_shmakov@oparina4.ru, https://orcid.org/0000-0002-2206-1002, 117997, Russia, Moscow, Academician Oparin str., 4.
Authors' contributions: Efremov P.I., Efremov A.P., Kryukov V.A., Bondarevsky I.Ya., Sherstobitov A.V., Fortygin A.Ya., Fortygina Yu.A., Shmakov R.G. – development of the design of the investigation, obtaining data for analysis, review of publications on the topic of the article, analysis of the findings, writing the text of the manuscript.
Conflicts of interest: The authors declare that there are no possible conflicts of interest.
Funding: The investigation has not been sponsored.
Patient Consent for Publication: The patient provided informed consent for the publication of her data and associated images.
For citation: Efremov P.I., Efremov A.P., Kryukov V.A., Bondarevsky I.Ya., Sherstobitov A.V., Fortygin A.Ya., Fortygina Yu.A., Shmakov R.G. Delivery after advanced abdominal pregnancy.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2022; 7: 142-148 (in Russian)
https://dx.doi.org/10.18565/aig.2022.7.142-148
Similar Articles
