Full-term abdominal pregnancy
Abdominal pregnancy (AР) is a very rare form of ectopic pregnancy. This pathology detected at different stages of pregnancy is accompanied by a large number of serious maternal and fetal complications. The clinical manifestations of AP are very diverse and nonspecific. However, only with this oval localization, the pregnancy may progress to full term. It is obvious that surgery is inevitable at early diagnosis of АР. In most cases, the diagnosis of full-term AP is made only intraoperatively; moreover, acute abdomen and hemorrhagic shock are often indications for surgery. To identify AP, a physician should display special vigilance for this pathology. The full-term AP cases described in the literature are casuistic, so each of them is sure to be of scientific and practical interest.Ivanova N.A., Kormakova T.L., Ukvalberg M.E., Lazareva A.A., Shvedkina N.N.
Case report. The paper describes a clinical case of abdominal pregnancy at 37 weeks’ gestation, which ended successfully for the mother and fetus. Indications for operative delivery were urgently set due to suspected premature placental abruption. The fetus was located freely in the abdominal cavity; a live full-term girl with no visible malformations was delivered in breech presentation; she had an Apgar score of 8/8. The placenta was located in the area of the left uterine appendages and in the space of Douglas, without damaging other abdominal organs and large major vessels. Despite this, the intraoperative blood loss was 4000 ml and required massive blood transfusion therapy.
Conclusion. The described clinical case should once again draw the attention of clinicians and ultrasound diagnosticians to the problem of such a rare and very dangerous pathology, as AP. Since this case occurred in a remote northern region of Karelia, it was necessary to engage an air ambulance service, thanks to which highly qualified specialists were timely delivered to the operating room, which undoubtedly contributed to a favorable outcome.
Keywords
ectopic pregnancy
abdominal pregnancy
full-term abdominal pregnancy
favorable outcome
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Received 27.10.2020
Accepted 29.01.2021
About the Authors
Natalya A. Ivanova, Candidate of Medical Sciences, Associate Professor of the Department of Obstetrics and Gynecology, Dermatovenereology, Petrozavodsk State University. E-mail: natalia-691969@mail.ru. ORCID: 0000-0001-5380-6006. 185910, Russia, Republic of Karelia, Petrozavodsk, Lenina str., 33.Tamara L. Kormakova, Candidate of Medical Sciences, Associate Professor of the Department of Obstetrics and Gynecology, Dermatovenerology, Petrozavodsk State University. E-mail: tamarakor@list.ru. ORCID: 0000-0003-0027-0353. 185910, Russia, Republic of Karelia, Petrozavodsk, Lenina str., 33.
Marina E. Ukvalberg, Candidate of Medical Sciences, Associate Professor of the Department of Obstetrics and Gynecology, Dermatovenereology, Petrozavodsk State University. E-mail: ukvalbergm@mail.ru. ORCID: 0000-0003-4287-6943. 185910, Russia, Republic of Karelia, Petrozavodsk, Lenina str., 33.
Anna A. Lazareva, Head of the Maternity Department, Regional Hospital No.1, Kostomuksha. 186930, Russia, Republic of Karelia, Kostomuksha, Mira str., 9.
Natalya N. Shvedkina, doctor of the maternity ward, Regional Hospital No.1, Kostomuksha. E-mail: natalyashvedkina@mail.ru.
186930, Russia, Republic of Karelia, Kostomuksha, Mira str., 9.
For citation: Ivanova N.A., Kormakova T.L., Ukvalberg M.E., Lazareva A.A., Shvedkina N.N. Full-term abdominal pregnancy.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2021; 5: 180-184 (in Russian)
https://dx.doi.org/10.18565/aig.2021.5.180-184
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