Lessons learned from four advanced abdominal pregnancies at an East African Health Center
Willibald Zeck1, Ingrid Kelters, Raimund Winter
1Department of Obstetrics and Gynecology, Medical University of Graz, Austria and Mikumi Health Center, Morogoro District, Tanzania, East Africa. willibald.zeck@meduni-graz.at
Aims:
To analyze diagnosis and treatment of four advanced abdominal pregnancies in a low-resource setting of a developing country.
Methods:
Extrauterine pregnancies occurring between 1997 and 2003 were identified from hospital records of the Mikumi Health Center in Tanzania/East Africa.
Results:
A total of 45 extrauterine pregnancies were diagnosed four of which were advanced and located in the abdominal cavity. At the time of diagnosis, pregnancies were at 33, 34, 36 and 39 weeks of gestation, respectively. All four mothers survived but three of four fetuses died. One child is alive and well three years after delivery.
Conclusion:
Abdominal pregnancy is rather difficult to detect in a low-resource setting of a developing country. Persistent abdominal pain and tenderness, as well as fetal movements in the upper abdomen associated with abnormal fetal lie, may lead to its diagnosis. Localizing the fetal heart sounds in the maternal epigastrium especially in patients with abdominal pain may also be helpful in diagnosing an abdominal pregnancy. In addition, the lack of cervical changes or a displaced cervix should lead to the suspicion of an abdominal pregnancy.
Related Concept Videos
01:25Assessment of the Abdomen I: Inspection and Auscultation
The abdominal examination is a cornerstone of clinical medicine, serving as a critical tool in diagnosing various gastrointestinal (GI) diseases. It involves a systematic approach that includes inspection and auscultation, each with distinct yet complementary roles in assessing the abdomen. This article will delve into these two primary methods healthcare professionals use to examine the abdomen.
Inspection of the Abdomen
The first step in any abdominal examination is inspection.
01:20Ultrasound I: Abdominal Ultrasonography
Abdominal ultrasonography, commonly known as abdominal ultrasound, is a vital, non-invasive medical imaging technique widely used in healthcare.
Procedure:
This diagnostic tool allows the clinician to visually inspect internal structures within the abdomen, including vital organs such as the liver, gallbladder, pancreas, kidneys, and spleen.
The abdominal ultrasound process begins with applying a special gel to the patient's skin over the abdomen. This gel enhances the...
01:18Assessment of the Abdomen II: Percussion
Percussion
Percussion is an essential...
01:19Abdominal Regions and Quadrants
The simpler quadrants approach, which is more commonly used in medicine, subdivides the cavity with one horizontal and one vertical line that intersects at the patient's umbilicus (navel). The four quadrants...