ABSTRACT
@#Advanced abdominal pregnancy is associated with catastrophic outcomes for both mother and fetus. Because it is rare, it is often misdiagnosed and the surgery, often unplanned, may end up with uncontrollable hemorrhage and injury to abdominal structures during placental removal. A case of a 21-year-old G1P0, 34 weeks gestation, who presented as a bleeding placenta previa but diagnosed intraoperatively as abdominal pregnancy with a live baby with congenital anomalies, with complete removal of the placenta and with good maternal outcome is presented. This report highlights the pitfalls in diagnosis and stresses the importance of team management, adherence to good surgical principles, and timely operative decisions to ensure a successful outcome when preoperative evaluation is not possible.
Subject(s)
Pregnancy, EctopicABSTRACT
A brief review of the literature on ovarian pregnancy is made. A case of on ovarian pregnancy in which a live baby was delivered abdominally is reported. Although ovarian pregnancy is one of the rarest forms of extrauterine pregnancy, its incidence is generally estimated to be between 0.7% to 1.07% of all ectopic gestations, or one ovarian pregnancy in 25,000 to 40,000 pregnancies. At Siriraj Hospital, an incidence of ovarian pregnancy is about 2.5% of all ectopic gestations, or one ovarian pregnancy in 8,100 pregnancies. Of these cases over 95% occurred before the 28th week of gestition. There were onlyu a few patients who delivered after the 28th week with a viable baby. The symptoms of ovarian pregnancy differ slightly from those of the more common forms of ectepic gestation. In case of advanced ovarian pregnancy, there may not be a profound difference from normal intrauterine pregnancy or abdominal pregnancy. Therefore it is virtually impossible to make a preoperative clinical diagnosis.