Chronicles of an uncommon term abdominal pregnancy with successful outcome: a case report
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Date
2024-01-24
Journal Title
Journal ISSN
Volume Title
Publisher
BioMed Central
Abstract
Abstract
Background Intra-abdominal pregnancies, while rare, present with unique diagnostic and management challenges. We present a case of a 25-year-old para 2+1, black African woman, who was referred from a peripheral Health Centre level IV in the Northern part of Uganda to a Regional Referral Hospital due to an abnormal presentation with easily palpable fetal parts. This case emphasizes the signifcance of prompt diagnosis, interdisciplinary collaboration, surgical planning, and managing the placenta in advanced intra-abdominal pregnancies.
Case presentation A 25 year African black female, para 2+1 upon arrival at Regional Referral Hospital, a University
Teaching Hospital during a weekend, an ultrasound was sourced from a nearby private clinic revealing an extra-uterine intra-abdominal pregnancy at 38 weeks of gestation and she was promptly sent back to the University Teaching Hospital. Following this diagnosis, the patient, who hailed from a remote village over 30 km away, returned to her family for discussions. After three days, she was readmitted. Emergency laparotomy unveiled an omental gestation sac with extensive placental attachment. A live female infant was delivered successfully, placenta was left in situ. The post-operative course was uneventful, with initial concerns about inadequate breast milk fow which resolved after placental removal during the second exploratory laparotomy.
Conclusion This case highlights the uncommon occurrence of an advanced intra-abdominal pregnancies and emphasizes the importance of multi-disciplinary teamwork and placental management. The favorable outcome in the management was based on thorough assessment of the placental location, attachments and blood supply during surgery. It demonstrates the possibility of reduced risk of massive bleeding if there is a delayed removal of placenta with favorable attachment. This is particularly important for milk letdown as well as reducing the needs of blood transfusion in resource limited settings.
Description
Its a case report.
Keywords
Intra-abdominal pregnancy, Interdisciplinary collaboration, Exploratory laparotomy, Placental location, Surgical planning, Placental management
Citation
Magezi, J., Wacha, J., & Pebalo, P. F. (2024). Chronicles of an uncommon term abdominal pregnancy with successful outcome: a case report. Journal of Medical Case Reports, 18(1), 1-6.