ABSTRACT
Authors report a case of abdominal pregnancy diagnosed by MRI at 17 SA with prospective follow-up and planned delivery at 37 SA. The diagnosis is clinically suspected when extra-uterine pregnancy risk factors or history of uterine trauma are present. This is confirmed by MRI, which may be considered as the gold standard. A conservative management may be proposed when the diagnosis is made after 20 weeks and under the following conditions: absence of fetal growth malformation, placental implantation remote from the upper abdomen, good maternal condition, close management in a hospital setting of the patient previously informed of the risks and outcomes. Placental location on the uterus seems to be a major positive factor of outcome for these pregnancies. Materno-fetal follow-up is based on physical examination, repeated ultrasonic investigations with Doppler imaging and daily fetal heart rate monitoring. In the absence of complications, a laparotomy should be planned at 34 weeks. The placenta may not be removed when a serious risk of hemorrhage is feared.
Subject(s)
Gestational Age , Pregnancy, Abdominal/diagnosis , Pregnancy, Abdominal/therapy , Female , Fetal Monitoring , Heart Rate, Fetal , Humans , Magnetic Resonance Imaging , Pregnancy , Pregnancy Outcome , Risk Factors , Ultrasonography, PrenatalABSTRACT
We report the anaesthetic management of an abdominal pregnancy. The delivery was obtained by laparotomy, under general anaesthesia, by a multi-specialist team. Abdominal pregnancy carries a high foetal and maternal risk for morbidity and lethal outcome. The main complication is sudden haemorrhage which can occur at any time.
Subject(s)
Anesthesia, General , Anesthesia, Obstetrical , Cesarean Section , Pregnancy, Abdominal/surgery , Adult , Female , Humans , Laparotomy , Magnetic Resonance Imaging , Postpartum Hemorrhage/prevention & control , Pregnancy , Pregnancy, Abdominal/complications , Pregnancy, Abdominal/pathologySubject(s)
Anesthesia, Obstetrical , Cardiomyopathy, Hypertrophic , Cesarean Section , Echocardiography, Transesophageal , Monitoring, Intraoperative , Pregnancy Complications, Cardiovascular , Adult , Cardiomyopathy, Hypertrophic/physiopathology , Female , Humans , Pregnancy , Pregnancy Complications, Cardiovascular/physiopathologyABSTRACT
Post operative pain is a constant and deleterious factor, resulting from surgical traumatism of the operated tissues; this aggression leads to a local inflammatory and painful reaction mediated by prostaglandins. Non steroid anti-inflammatory drugs inhibit their synthesis. In this study, ketoprofene appears to be an interesting treatment of post operative pain especially in orthopedic and traumatologic surgery.
