Dabiri Tajudeen, Marroquin Guillermo A, Bendek Boleslaw, Agamasu Enyonam, Mikhail Magdy
Department of Obstetrics and Gynecology, Bronx Lebanon Hospital, Bronx, NY, USA.
Biomed Res Int. 2014;2014:102479. doi: 10.1155/2014/102479. Epub 2014 Dec 3.
Abdominal pregnancy is a very rare form of ectopic pregnancy, associated with high morbidity and mortality for both fetus and mother. It is, and often, seen in poor resource nations, where early diagnosis is often a major challenge due to poor prenatal care and lack of medical resources. An advanced abdominal pregnancy with a good fetal and maternal outcome is therefore a more extraordinary occurrence in the modern developed world. We present a case of an abdominal pregnancy at 33.4 weeks in an individual with no documented prenatal care, who arrived in a hospital in the Bronx, in June 25th 2014, with symptoms of generalized, severe lower abdominal pain. Upon examination it was found that due to category III fetal tracing an emergent cesarean section was performed. At the time of laparotomy the fetus was located in the pelvis covered by the uterine serosa, with distortion of the entire right adnexa and invasion to the right parametrium. The placenta invaded the pouch of Douglas and the lower part of the sigmoid colon. A massive hemorrhage followed, followed by a supracervical hysterectomy. A viable infant was delivered and mother discharged on postoperative day 4.
腹腔妊娠是一种非常罕见的异位妊娠形式，对胎儿和母亲均具有较高的发病率和死亡率。它常见于，且往往多见于资源匮乏的国家，在这些国家，由于产前护理不佳和医疗资源匮乏，早期诊断常常是一项重大挑战。因此，在现代发达国家，能有良好胎儿和母亲结局的晚期腹腔妊娠更是一种非同寻常的情况。我们报告一例腹腔妊娠病例，患者妊娠33.4周，未进行过产前检查记录，于2014年6月25日因下腹部广泛性剧痛症状入住布朗克斯区一家医院。经检查发现，由于胎儿监护为III类，遂紧急实施剖宫产。剖腹探查时，胎儿位于被子宫浆膜覆盖的盆腔内，整个右侧附件变形，侵犯右侧子宫旁组织。胎盘侵入Douglas陷凹和乙状结肠下部。随后发生大量出血，接着实施了次全子宫切除术。娩出一名存活婴儿，母亲术后第4天出院。
