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Intraoperative Strategy under Complex Vascular Adhesion for Laparoscopic Radical Resection of Bismuth-Corlette Type IIIb Perihilar Cholangiocarcinoma
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Primary Abdominal Pregnancy: A Case Report.

Sunita Dubey1, Mohit Satodiya2, Priyanka Garg2

  • 1Assistant Professor, Department of Obstetrics and Gynaecology, GMCH , Sector 32, Chandigarh, India .

Journal of Clinical and Diagnostic Research : JCDR
|January 5, 2017
PubMed
Summary
This summary is machine-generated.

Abdominal pregnancy is a rare, life-threatening ectopic gestation. Early ultrasound is crucial before pregnancy termination, especially with persistent gastrointestinal symptoms, to prevent severe maternal complications.

Keywords:
Abdominal pregnancyAdnexal massEctopic PregnancyHaemorrhagic shock

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Area of Science:

  • Reproductive Medicine
  • Surgical Gynecology
  • Emergency Medicine

Background:

  • Abdominal pregnancy, a rare form of ectopic gestation (1% of all ectopic pregnancies), poses significant risks, including maternal mortality from hemorrhage.
  • Advanced gestation and viable fetal outcomes are exceptionally rare due to poor prognosis and risk of placental separation.

Observation:

  • A 30-year-old patient presented with hemorrhagic shock at 7+2 weeks gestation, experiencing persistent gastrointestinal symptoms.
  • Initial management involved termination of pregnancy via dilatation and curettage without prior ultrasound.
  • Post-procedure, the patient's condition worsened, leading to hemorrhagic shock and requiring emergency laparotomy.

Findings:

  • Laparotomy revealed 3 liters of hemoperitoneum, a 10+2 week fetus, and a separated placenta within the abdominal cavity, implanted on the sigmoid colon.
  • The uterus appeared consistent with a 10-12 week gestation, and adnexa were healthy.
  • The patient required significant blood transfusion and recovered satisfactorily post-surgery.

Implications:

  • This case underscores the critical importance of ultrasound to rule out abdominal pregnancy before any termination procedure, particularly in patients with atypical gastrointestinal symptoms.
  • Failure to diagnose abdominal pregnancy pre-procedure can lead to catastrophic maternal complications like hemorrhagic shock.
  • Timely diagnosis and appropriate management, including surgical intervention when necessary, are vital for improving outcomes in abdominal pregnancy.