Pregnancy normally settles in the uterus and continues to
grow until birth. It is called the formation of pregnancy in the tubes,
ovaries, cervix outside the uterus. In abdominal pregnancy, apart from all
these places, the placement takes place in the peritoneal cavity in the
abdomen. Abdominal pregnancy can be defined as a type of ectopic pregnancy.
Approximately 1% of ectopic pregnancies are abdominal pregnancies and mortality
rate is around 0.5%. Its incidence is reported in around 10 thousand to 30
thousand pregnancies. Abdominal pregnancy can also develop in hysterectomized
patients.
Among the types of ectopic pregnancy, morbidity and mortality
are the highest. The most recently diagnosed ectopic pregnancy is abdomial
pregnancies.
Abdominal pregnancy can be implanted in various organs such
as liver, spleen, intestine, omentum, pelvic side walls, broad ligament,
diaphragm in the abdomen. In a case report, it was reported that pregnancy
implanted in the liver was treated with methotrexate treatment and potassium
chloride injection without surgical treatment.
If an abdominal pregnancy occurs when the sperm and ovum are
fertilized directly in the abdomen, this is called primary abdominal pregnancy.
If the pregnancy occurs after tubert abortion after the fertilization has
occurred in the tub, it is called secondary abdominal pregnancy. Abdominal
pregnancies that meet Studdiford criteria are classified as perimer abdominal
pregnancy, these criteria are:
- Tuba and ovaries have normal structure
- No uteroplacental fistula
- To exclude the possibility of tubal abortion, the sac is
only attached to the peritoneal surface in early gestational weeks.
Symptoms:
Symptoms may vary depending on the location of the abdominal
pregnancy. Sometimes it may not be noticed until the very advanced months of
pregnancy or even the term. Complications such as pain, intraabdominal
bleeding, abdominal organ ruptures, hemorrhagic shock may occur. There are
abdominal pregnancies that result in live birth in term. In abdominal
pregnancies, congenital anomalies belonging to the baby are more common than
normal. IUGR, facial and limb defects are common in the baby.
Very rarely, in the abdominal pregnancy, the fetus dies and
"petrifies" as calcified, it can remain in the womb for years without
being noticed in this way
Despite the increase in the hormone B-HCG, the inability to
monitor pregnancy in the uterus and tuba creates the main suspicion and
diagnosis is made with methods such as ultraosonography, MR, CT.
Risk factors:
- PID (Pelvic inflammatory disease)
- Multiparite
- Assisted reproductive techniques such as IVF and ICSI
Treatment:
Although surgical treatment is the primary method, rarely
methotrexate treatment is also used. However, methotrexate therapy is not as
successful as in tubal ectopic pregnancies. Very serious bleeding can occur
during surgery, especially during the removal of the placenta. Therefore,
laparotomy is preferred. However, there are also cases treated with
laparoscopy. In some cases, due to the risk of bleeding, only the fetus was
removed and the placenta was left in place and methotrexate treatment was
given.
-QUESTIONS ABOUT ABORTION
-RISKS OF ABORTION
-PIECES THAT ARE LEFT IN THE WOMB DURING ABORTION
-MENSTRUATION AND MENSTRUAL DELAY AFTER AN ABORTION
-BLEEDING AFTER AN ABORTION
-MISCARRIAGE
-RECURRENT MISCARRIAGES
-ABDOMINAL PREGNANCY
