How does abdominal pregnancy occur

There were dense adhesions between the posterosuperior aspect of the uterus and the amniotic membrane. The right tube and ovary were found to be normal while the left tube and ovary could not be visualized because of dense adhesions.

The placenta was removed in toto and the abdomen closed in layers. Four units of blood were transfused intraoperatively. The postoperative period was uneventful. Intra-abdominal pregnancy is a type of ectopic pregnancy wherein the fetus grows in the abdominal cavity. The extrauterine implantation can occur in the omentum, the large vessels or even in the vital organs.

Abdominal pregnancies account for 0. Risk factors associated with abdominal pregnancy include tubal damage, pelvic inflammatory disease, endometriosis, assisted reproductive techniques and multiparity. Clinical history and physical examination alone may be insufficient to make a preoperative diagnosis. Sonography is the most effective method for diagnosing an abdominal pregnancy.

MRI is an emerging important, complementary imaging modality that helps not only to confirm the diagnosis but also to delineate the precise anatomical relationship between the fetus and various maternal abdominal organs. Abdominal pregnancy occurs either as a result of tubal abortion or rupture secondary abdominal pregnancy or rarely as a result of primary peritoneal implantation primary abdominal pregnancy.

Studdiford established three criteria for diagnosing primary peritoneal pregnancies: 1 normal bilateral fallopian tubes and ovaries; 2 the absence of uteroperitoneal fistula; and 3 a pregnancy related exclusively to the peritoneal surface and early enough to eliminate the possibility of secondary implantation following a primary nidation in the tube.

The mortality of abdominal pregnancy is 7. Fetal malformations such as torticollis, facial asymmetry, malformation of limbs, flattening of the head and thorax, etc. Abdominal pain is the most frequent symptom. Rarely, symptoms may relate to placental site attachment, including attachment to the bowel or bladder obstruction. Sonographic features denoting abdominal pregnancy include fetus being seen outside the uterine cavity, absence of the uterine wall between bladder and fetal parts, oligohydramnios, fetal parts located close to the maternal abdominal wall, and abnormal location of placenta outside the uterine cavity.

The role of MRI is to locate the placenta and identify its adherence to any vital organs, including the liver and spleen. In this case, MRI not only helped confirm the diagnosis, but it delineated the exact anatomical localization of fetal parts and placental tissue as well as the adhesions to the uterus. This information proved vital in preoperative planning. The information on the location, state of viability of the placenta and blood supply will influence management and aid in planning surgery.

Preoperative angiograms can be useful in locating all sources of vascular supply to the placenta and if possible to embolize vessels difficult to ligate operatively.

If the placenta is not removed during laparotomy, postoperative embolization of feeding arteries can be done to control hemorrhage from adherent placenta. Previous scans of our patient were read as an intrauterine pregnancy. She also had a history of first-trimester abdominal with spotting per vaginum, which might have been due to either a tubal abortion or a tubal rupture with the conceptus getting implanted into the peritoneal cavity.

This had gone unnoticed with the fetus growing as an abdominal pregnancy. The indications of an abdominal pregnancy are initially the same as those of a normal pregnancy: amenorrhoea, positive pregnancy test, common pregnancy symptoms such as nausea and breast tenderness. If the progeny develops further, this can cause pain in the vagina, severe nausea and circulatory problems. If the egg cell does not die early, the abdominal pregnancy will usually be discovered during the first pregnancy check-up.

Early stages of pregnancy can sometimes be ended with medication by injecting it directly into the progeny. However, an ectopic pregnancy must usually be ended surgically. With a laparoscopic procedure. Find out more about laparoscopic surgery in the laparoscopy section.

From there, it implants for the second time — this time, in the abdomen. Diagnosing an abdominal pregnancy is difficult, Rabin said. Other symptoms include painful fetal movements, and gastrointestinal problems.

Also, if it's too easy to feel the baby, or see it with an ultrasound , that might be a sign that the baby is outside the uterus, Rabin said. If doctors find that a fetus is growing outside the uterus, they make an incision in the pregnant woman's abdomen, to deliver the baby. The placenta is often left to be absorbed by the body, because removing the placenta can cause severe bleeding. Most of the babies that Rabin has seen in abdominal pregnancies were healthy, she told Live Science.