ABSTRACT
Background: Abdominal pregnancy, a rare condition with high maternal mortality (up to 50%), and even higher perinatal mortality (40 95%), is often associated with diagnostic difficulties. Objectives: To determine the mode of presentation and management of abdominal pregnancy, from cases in the Usmanu Dan-Fodiyo University Teaching Hospital (UDUTH), Sokoto. Materials and Methods: A retrospective review of the case records of all abdominal pregnancies managed in UDUTH, Sokoto, between January 2000 and December 2010. Results: During the 10-year study period, there were eight cases of abdominal pregnancies, 285 extrauterine pregnancies, and 25,506 total deliveries. All the patients were not booked for antenatal care and their ages ranged between 20 and 39 years (mean=28.1±3.4 years). The majority (88%) were grand multipara. The main presenting symptoms were persistent abdominal pain, vaginal bleeding, and prolonged pregnancy. Seven cases (87.5%) were diagnosed accurately by an ultrasound scan. There were seven perinatal deaths (87.5%) and one live birth. There was one maternal death (12.5%), which occurred in the patient whose placenta was left in-situ. Conclusion: Presence of persistent lower abdominal pain, vaginal bleeding, and prolonged pregnancy should raise the suspicion of abdominal pregnancy. Removal of the placenta, where feasible, improves the outcome of maternal health
Subject(s)
Hospitals, Teaching , Pregnancy, Abdominal/complications , Pregnancy, Abdominal/diagnosis , Pregnancy, Abdominal/mortality , ReviewABSTRACT
El embarazo ectópico es una entidad extremadamente peligrosa que, de no realizar un diagnóstico adecuado y un tratamiento precoz, conlleva una alta mortalidad. En las últimas décadas ha aumentado la frecuencia, oscilando entre 4,5 y 12,5 por mil embarazos. Hemos realizado un estudio retrospectivo tomando como base un caso que tuvimos la oportunidad de tratar mientras nos encontrábamos cumpliendo misión internacionalista en Guatemala. Se presenta el testimonio gráfico del mismo.
Ectopic pregnancy is an extremely dangerous entity, leading to a high mortality if an adequate diagnosis and an early treatment are not made. During the last decades its frequency has increased, oscillating form 4, 5 to 12, 5/1 000 pregnancies. We carried out a retrospective study, beginning from a case we attended when were in an international mission in Guatemala. We present a graphic testimony of the case.
Subject(s)
Humans , Female , Adult , Pregnancy, Abdominal/diagnosis , Pregnancy, Abdominal/epidemiology , Pregnancy, Abdominal/mortality , Pregnancy, Abdominal/therapy , GuatemalaABSTRACT
El embarazo abdominal (EA) es una gestación ectópica potencialmente fatal que se ubica dentro de la cavidad peritoneal. Esta patología es a menudo no sospechada y es un desafío diagnóstico bastante frecuente para el clínico. La mortalidad materna se estima de 0,5-18 por ciento (1,2) y la mortalidad perinatal alcanza rangos entre 40-95 por ciento (3,4). Existen 10.8 EA por 100.000 nacimientos y 9,2 EA por 1.000 embarazos ectópicos en los Estados Unidos(2). El riesgo de muerte materna con un embarazo abdominal es de 7.7 veces mayor que con un embarazo ectópico tubario y 90 veces mayor que con un embarazo intrauterino. De acuerdo a los múltiples factores de riesgo que abarca esta patología se discuten los métodos diagnósticos y terapeúticos tratando de mejorar de esta forma el pronóstico materno y fetal