PDF herunterladen
AJP Rep 2014; 4(01): 055-060
DOI: 10.1055/s-0034-1371749
Case Report
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Conservative Management of an Advanced Abdominal Pregnancy at 22 Weeks

Louis Marcellin
1   Maternité Port-Royal, Groupe hospitalier Cochin, Broca, Hôtel-Dieu, Assistance Publique–Hôpitaux de Paris, Paris, France
2   DHU Risques et Grossesse, Université Paris Descartes, Paris, France
,
Sophie Ménard
1   Maternité Port-Royal, Groupe hospitalier Cochin, Broca, Hôtel-Dieu, Assistance Publique–Hôpitaux de Paris, Paris, France
2   DHU Risques et Grossesse, Université Paris Descartes, Paris, France
,
Marie-Charlotte Lamau
1   Maternité Port-Royal, Groupe hospitalier Cochin, Broca, Hôtel-Dieu, Assistance Publique–Hôpitaux de Paris, Paris, France
,
Alexandre Mignon
3   Université Paris Descartes, Assistance Publique-Hôpitaux de Paris, Paris, France
4   Department of Anaesthesia and Critical Care Paris, Cochin University Hospital, Paris, France
,
Marie Stephanie Aubelle
2   DHU Risques et Grossesse, Université Paris Descartes, Paris, France
5   Service de Médecine et Réanimation néonatales de Port-Royal, Groupe hospitalier Cochin, Broca, Hôtel-Dieu, Assistance Publique–Hôpitaux de Paris, Paris, France
,
Gilles Grangé
1   Maternité Port-Royal, Groupe hospitalier Cochin, Broca, Hôtel-Dieu, Assistance Publique–Hôpitaux de Paris, Paris, France
2   DHU Risques et Grossesse, Université Paris Descartes, Paris, France
,
François Goffinet
1   Maternité Port-Royal, Groupe hospitalier Cochin, Broca, Hôtel-Dieu, Assistance Publique–Hôpitaux de Paris, Paris, France
2   DHU Risques et Grossesse, Université Paris Descartes, Paris, France
› Institutsangaben
Weitere Informationen

Publikationsverlauf

14. November 2013

20. Januar 2014

Publikationsdatum:
02. April 2014 (online)

Auch verfügbar auf
   Lizenzen und Reprints

Abstract

Objective We report an uneventful conservative approach of an advanced abdominal pregnancy discovered at 22 weeks of gestation.

Study Design This study is a case report.

Results Attempting to extend gestation of an advanced abdominal pregnancy is not a common strategy and is widely questioned. According to the couple's request, the management consisted in continuous hospitalization, regular ultrasound scan, and antenatal corticosteroids. While the woman remained asymptomatic, surgery was planned at 32 weeks, leading to the birth of a preterm child without any long-term complications. Placenta was left in situ with a prophylactic embolization, and its resorption was monitored.

Conclusion Depending on multidisciplinary cares and agreement of the parents, when late discovered, prolonging advanced abdominal pregnancy appears to be a reasonable option.

Keywords

advanced abdominal pregnancy - preterm delivery - placental embolization
 

  • References

  • 1 Gayer G. Images in clinical medicine. Abdominal ectopic pregnancy. N Engl J Med 2012; 367 (24) 2334
    CrossrefPubMedSuche in Google Scholar
  • 2 Farquhar CM. Ectopic pregnancy. Lancet 2005; 366 (9485) 583-591
    CrossrefPubMedSuche in Google Scholar
  • 3 Oneko O, Petru E, Masenga G, Ulrich D, Obure J, Zeck W. Management of the placenta in advanced abdominal pregnancies at an East african tertiary referral center. J Womens Health (Larchmt) 2010; 19 (7) 1369-1375
    CrossrefPubMedSuche in Google Scholar
  • 4 Hallatt JG, Grove JA. Abdominal pregnancy: a study of twenty-one consecutive cases. Am J Obstet Gynecol 1985; 152 (4) 444-449
    CrossrefPubMedSuche in Google Scholar
  • 5 Beddock R, Naepels P, Gondry C , et al. [Diagnosis and current concepts of management of advanced abdominal pregnancy]. Gynecol Obstet Fertil 2004; 32 (1) 55-61
    CrossrefPubMedSuche in Google Scholar
  • 6 Bertrand G, Le Ray C, Simard-Emond L, Dubois J, Leduc L. Imaging in the management of abdominal pregnancy: a case report and review of the literature. J Obstet Gynaecol Can 2009; 31 (1) 57-62
    PubMedSuche in Google Scholar
  • 7 Martin Jr JN, McCaul IV JF. Emergent management of abdominal pregnancy. Clin Obstet Gynecol 1990; 33 (3) 438-447
    CrossrefPubMedSuche in Google Scholar
  • 8 Rackelboom T, Tsatsaris V, Silvera S, Vignaux O, Goffinet F, Mignon A. Anomalies d'insertion placentaire: prise en charge anesthésique. Le Praticien en Anesthésie Réanimation 2011; 15 (6) 359-366
    CrossrefPubMedSuche in Google Scholar
  • 9 Hreshchyshyn MM, Bogen B, Loughran CH. What is the actual present-day management of the placenta in late abdominal pregnancy? Analysis of 101 cases. Am J Obstet Gynecol 1961; 81: 302-317
    PubMedSuche in Google Scholar
  • 10 Cardosi RJ, Nackley AC, Londono J, Hoffman MS. Embolization for advanced abdominal pregnancy with a retained placenta. A case report. J Reprod Med 2002; 47 (10) 861-863
    PubMedSuche in Google Scholar
  • 11 Kerr A, Trambert J, Mikhail M, Hodges L, Runowicz C. Preoperative transcatheter embolization of abdominal pregnancy: report of three cases. J Vasc Interv Radiol 1993; 4 (6) 733-735
    CrossrefPubMedSuche in Google Scholar
  • 12 Rahaman J, Berkowitz R, Mitty H, Gaddipati S, Brown B, Nezhat F. Minimally invasive management of an advanced abdominal pregnancy. Obstet Gynecol 2004; 103 (5 Pt 2) 1064-1068
    CrossrefPubMedSuche in Google Scholar
  • 13 Valenzano M, Nicoletti L, Odicino F, Cocuccio S, Lorenzi P, Ragni N. Five-year follow-up of placental involution after abdominal pregnancy. J Clin Ultrasound 2003; 31 (1) 39-43
    CrossrefPubMedSuche in Google Scholar
  • 14 Bajo JM, Garcia-Frutos A, Huertas MA. Sonographic follow-up of a placenta left in situ after delivery of the fetus in an abdominal pregnancy. Ultrasound Obstet Gynecol 1996; 7 (4) 285-288
    CrossrefPubMedSuche in Google Scholar
  • 15 Skubisz MM, Tong S. The evolution of methotrexate as a treatment for ectopic pregnancy and gestational trophoblastic neoplasia: a review. ISRN Obstet Gynecol 2012; 2012: 637094
    PubMedSuche in Google Scholar