Ouahigouya University Teaching Hospital, Ouahigouya, BP, 36, Burkina Faso.
Yalgado Ouédraogo University Teaching Hospital of Ouagadougou, 03 BP 7022, Ouagadougou, 03, Burkina Faso.
BMC Pregnancy Childbirth. 2018 Nov 19;18(1):448. doi: 10.1186/s12884-018-2071-z.
Abdominal pregnancy is defined as the partial or total insertion of the embryo into the abdominal cavity. It is rare, and can evolve towards the full term if it is not recognized in the early pregnancy. It carries a high risk of maternal-fetal morbidity and mortality.
We report a case of a 22 year-old gravida IV, para II with an asymptomatic and undiagnosed abdominal pregnancy presumed full term, in a context of health centers under-equipment. She had attended 5 routine antenatal care, but had not performed any ultrasound scan. She had been transferred from a medical center to the Hospital of Ouahigouya (Burkina Faso) for bowel sub-obstruction and intrauterine fetal death, with failure of labor induction. On admission, the hypothesis of uterine rupture or abdominal pregnancy with antepartum fetal demise was considered. A laparotomy was then performed, where an abdominal pregnancy was discovered, and a dead term baby weighing 3300 g delivered. The placenta which was implanted into the ruptured isthmus of the left fallopian tube was removed by salpingectomy. Postoperative follow-up was uneventful.
This case report exposes the necessity for the practitioner to think about the possibility of abdominal pregnancy in his clinical and sonographic practice, irrespective of the gestational age, mainly in contexts where there is under-equipment of the health centers.
腹腔妊娠是指胚胎部分或完全植入腹腔。如果在早期妊娠中未被识别，它可能会向足月妊娠发展。它会导致母婴发病率和死亡率升高。
我们报告了一例 22 岁 IV 孕次，II 产次的无症状和未经诊断的腹腔妊娠，被认为是足月妊娠，发生在卫生中心设备不足的情况下。她曾接受过 5 次常规产前检查，但未进行任何超声检查。她从一家医疗中心转至瓦加杜古（布基纳法索）医院，原因是肠阻塞和宫内胎儿死亡，引产失败。入院时，考虑了子宫破裂或腹腔妊娠伴产前胎儿死亡的假说。随后进行了剖腹手术，发现了腹腔妊娠，并娩出了一名 3300 克重的死产婴儿。通过输卵管切除术切除了植入左侧输卵管峡部破裂处的胎盘。术后随访无异常。
本病例报告揭示了临床和超声实践中，无论妊娠年龄如何，特别是在卫生中心设备不足的情况下，医生都有必要考虑腹腔妊娠的可能性。
