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Advanced extra-uterine pregnancy.

A Golan, O Sandbank, A Andronikou

Acta Obstetricia Et Gynecologica Scandinavica

|January 1, 1985

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Advanced extra-uterine pregnancies are rare but serious. Diagnosis relies on vaginal exams and tests, with surgical removal of the placenta often successful, though risks to mother and infant remain.

Area of Science:

Obstetrics and Gynecology
Maternal-Fetal Medicine

Background:

Advanced extra-uterine pregnancy (more than 34 weeks' gestation) is a rare obstetric complication.
Previous studies highlight diagnostic challenges and management complexities.

Purpose of the Study:

To review cases of advanced extra-uterine pregnancy managed at Baragwanath Hospital.
To analyze diagnostic methods, treatment outcomes, and maternal/fetal prognosis.

Main Methods:

Retrospective review of 43 advanced extra-uterine pregnancy cases (1966-1978).
Analysis of clinical presentation, diagnostic aids (vaginal examination, oxytocin test, radiography, ultrasonography), and surgical management.
Evaluation of maternal and perinatal outcomes.

Main Results:

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Incidence was 1 in 6,389 deliveries.
Abdominal pain and vaginal bleeding were primary symptoms; vaginal examination proved more diagnostic than abdominal signs.
Placental removal was successful in 93% of cases, with 4 requiring hysterectomy.
Maternal mortality was 2/43; 8 of 18 live-born infants survived, all with congenital anomalies.

Conclusions:

Early diagnosis of advanced extra-uterine pregnancy is crucial, with clinical examination and specific tests aiding diagnosis.
While placental removal can be managed safely, significant risks of hysterectomy, maternal death, and infant morbidity/mortality persist.
Congenital anomalies are common in surviving infants, necessitating long-term follow-up.