A secondary abdominal pregnancy with unusual placental implantation in the fallopian tube: a diagnostic challenge

다국어 초록 (Multilingual Abstract)

We reported a case of secondary abdominal pregnancy with placental implantation into the fallopian tube, diagnosed at 16 weeks, in a woman admitted to the emergency room complaining of syncopal attacks. The best approach would be termination of the pregnancy, taking into consideration the high risk to the mother and the low possibility of alive and healthy birth. We had to perform an urgent surgical intervention due to the fact that the patient was in a clinically unstable condition, which was related to hemoperitoneum. If placental implantation is on abdominal organs or vessel the best approach would be to ligate the cord and to leave placenta in situ. Taking into consideration the place of placental implant, the removal of the fallopian tube with the placenta was the safest approach in this case. The best and most acceptable form of treatment would be individualized in case of rare form of ectopic pregnancy.

참고문헌 (Reference)

1 Ludwig M, "The forgotten child--a case of heterotopic, intra-abdominal and intrauterine pregnancy carried to term" 14 : 1372-1374, 1999

2 Varma R, "Successful outcome of advanced abdominal pregnancy with exclusive omental insertion" 21 : 192-194, 2003

3 Bouyer J, "Sites of ectopic pregnancy: a 10 year population-based study of 1800 cases" 17 : 3224-3230, 2002

4 Onan MA, "Primary omental pregnancy: case report" 20 : 807-809, 2005

5 Rahaman J, "Minimally invasive management of an advanced abdominal pregnancy" 103 : 1064-1068, 2004

6 Oneko O, "Management of the placenta in advanced abdominal pregnancies at an East african tertiary referral center" 19 : 1369-1375, 2010

7 Dover RW, "Management of a primary abdominal pregnancy" 172 : 1603-1604, 1995

8 Stevens CA, "Malformations and deformations in abdominal pregnancy" 47 : 1189-1195, 1993

9 Cosentino F, "Laparoscopic management of abdominal pregnancy" 24 : 724-725, 2017

10 Zinger M, "Failed treatment of abdominal pregnancy with methotrexate. A case report" 46 : 392-394, 2001

11 Cardosi RJ, "Embolization for advanced abdominal pregnancy with a retained placenta. A case report" 47 : 861-863, 2002

12 Beddock R, "Diagnosis and current concepts of management of advanced abdominal pregnancy" 32 : 55-61, 2004

13 Fisch B, "Abdominal pregnancy following in vitro fertilization in a patient with previous bilateral salpingectomy" 88 : 642-643, 1996

14 Ayinde OA, "Abdominal pregnancy at the University College Hospital, Ibadan: a ten-year review" 9 : 123-127, 2005

15 Li X, "A 16-week secondary abdominal ectopic pregnancy with a simultaneous intratubal placenta and abdominal fetus" 185 : 181-182, 2015