DIAGNOSIS :
ADVANCED LIVE SECONDARY ABDOMINAL PREGNANCY
USG FINDINGS:
Unusual fetal lie –fetal head in left lumbar region. Severe oligohydramnios. Symmetric IUGR csp to 23 to 24wks gestation with EFW 489+/- 78 gms. Absent myometrial tissue around the fetus. Poor definition of placenta. Presence of free maternal intraperitoneal fluid. Bulky uterus lying separately from the amniotic sac.
MR IMAGING: confirmed a single abdominal pregnancy posterior to the uterus with minimal invasion of the posterosuperior uterus. The probable site of placental attachment is omentum. Per-operative findings corresponded exactly with imaging findings.
DISCUSSION:
0.1% of pregnancies are abdominal. Can go undetected until an advanced gestational age and only 40% are diagnosed antenatally. Maternal mortality range from 0.5% to 18%.Perinatal mortality varies from 40 -95%. Associated morbidity includes massive antepartum bleeding, infection, anemia, disseminated intravascular coagulation, pulmonary embolism.
Case Contributed by Dr. Sudha Karnan
ADVANCED LIVE SECONDARY ABDOMINAL PREGNANCY
USG FINDINGS:
Unusual fetal lie –fetal head in left lumbar region. Severe oligohydramnios. Symmetric IUGR csp to 23 to 24wks gestation with EFW 489+/- 78 gms. Absent myometrial tissue around the fetus. Poor definition of placenta. Presence of free maternal intraperitoneal fluid. Bulky uterus lying separately from the amniotic sac.
MR IMAGING: confirmed a single abdominal pregnancy posterior to the uterus with minimal invasion of the posterosuperior uterus. The probable site of placental attachment is omentum. Per-operative findings corresponded exactly with imaging findings.
DISCUSSION:
0.1% of pregnancies are abdominal. Can go undetected until an advanced gestational age and only 40% are diagnosed antenatally. Maternal mortality range from 0.5% to 18%.Perinatal mortality varies from 40 -95%. Associated morbidity includes massive antepartum bleeding, infection, anemia, disseminated intravascular coagulation, pulmonary embolism.
Case Contributed by Dr. Sudha Karnan