Mforteh Ascensius Achuo, Tchakounte Collince, Sama Carlson-Babila, Eteme-Messi Stephane, Djiognouo Willy, Dohbit Sama, Foumane Pascal
Department of Obstetrics and Gynecology, University of Yaoundé 1, Yaoundé, Cameroon.
Hopital Saint Jean de Malte, Njombe, Cameroon.
Case Rep Obstet Gynecol. 2018 Sep 25;2018:4171604. doi: 10.1155/2018/4171604. eCollection 2018.
There are increasing reports of term live abdominal pregnancies even though the diagnosis of abdominal pregnancy is made preoperatively only in 45% of cases which partly explains the high maternal and perinatal morbidity and mortality associated with abdominal pregnancy.
We report a rare case of misdiagnosed term abdominal pregnancy complicated by fetal demise due to cord round neck in a 29-year-old G3P2002 at 39-week and 1-day gestation. She noticed reduced fetal movements for which upon examination fetal death was diagnosed. Cervical ripening was started which eventually failed, and surgery was indicated. Findings were an abdominal pregnancy with a third-degree macerated fetus with cord round neck. She was discharged on day 8 postoperation to continue follow-up as an outpatient with regular HCG and ultrasound checks.
This case illustrates the need to effectively confirm an intrauterine location of a pregnancy even in a case of fetal demise and the need to monitor for cord abnormalities in advanced abdominal pregnancy being managed expectantly.
尽管腹内妊娠的术前诊断仅在45%的病例中得以实现，但足月活产腹内妊娠的报道仍日益增多，这部分解释了与腹内妊娠相关的高孕产妇和围产期发病率及死亡率。
我们报告一例罕见病例，一名29岁、孕3产2（0-0-0-2）、妊娠39周零1天的孕妇，足月腹内妊娠误诊，并发因脐带绕颈导致的胎儿死亡。她注意到胎动减少，经检查诊断为胎儿死亡。开始进行宫颈成熟处理，但最终失败，遂行手术。术中发现为腹内妊娠，胎儿已三度浸软，伴有脐带绕颈。术后第8天她出院，作为门诊患者继续随访，定期进行人绒毛膜促性腺激素（HCG）和超声检查。
该病例表明，即使在胎儿死亡的情况下，也需要有效确认妊娠的子宫内位置，并且对于期待治疗的晚期腹内妊娠，需要监测脐带异常情况。
