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Early diagnosis of an abdominal pregnancy is difficult since it is associated with a wide range of signs and symptoms. However, ultrasound is the most effective method for diagnosing an abdominal ectopic pregnancy. We present a case of advanced abdominal ectopic pregnancy, which progressed to the second trimester and ended up with fetal death. Despite having repeated ultrasound scanning, the diagnosis was missed. This case report emphasizes the need for a high index of suspicion and correlation of the patient's signs and symptoms with ultrasound findings to make an early diagnosis of abdominal ectopic pregnancy. [ABSTRACT FROM AUTHOR]

This article provides a detailed analysis of the clinical and gynecologic characteristics of ectopic pregnancy based on the anatomical site. The study utilized nationwide databases to examine patient encounters with ectopic pregnancy from 2016 to 2020. The fallopian tube was found to be the most common site for ectopic pregnancy, followed by the cervico-corpus, ovary, and abdomen. The study revealed an increase in ovarian ectopic pregnancy over the study period, while cervico-corpal ectopic pregnancy decreased. Patients with abdominal ectopic pregnancy were more likely to be obese and have comorbidities. The article emphasizes the importance of further research to understand the physiological effects of endometrial gestation on extra-endometrial gestation. [Extracted from the article]

Zelan Xiao,1 Shengfang Long,2 Zhiqiang Yan,1 Zhen Chen,1 Lihui Lin,1 Yawen Cao1 1Department of Gynecology, Hainan Western Central Hospital, Danzhou City, Hainan Province, People’s Republic of China; 2Department of Obstetrics and Gynecology, Yangpu Economic Development Zone Hospital, Danzhou City, Hainan Province, People’s Republic of ChinaCorrespondence: Yawen Cao, Department of Gynecology, Hainan Western Central Hospital, No. 5, Wuxiang, Xinshijie Garden Community, Danzhou City, Hainan Province, 571700, People’s Republic of China, Tel +86 18876098257, Email caoyw2024yw@163.comAbstract: Abdominal pregnancy is a rare and life-threatening form of ectopic pregnancy. Although the underlying mechanism of this abnormal disorder is unknown, a number of risk factors have been identified, including pelvic inflammatory disease, history of pelvic surgery, intrauterine device use and previous ectopic pregnancy. Diaphragmatic rupture due to ectopic pregnancy is a rare and life-threatening condition that can lead to massive intraperitoneal haemorrhage and haemorrhagic shock. This report presents the case of a 21-year-old woman who presented with 7 weeks and 4 days of amenorrhoea and 14 hours of acute abdominal pain. On examination, she was in haemorrhagic shock with signs of acute abdomen. Emergency exploratory laparotomy revealed a haemoperitoneum of 1500 mL and active bleeding from a 3× 2 cm rupture in the right hemidiaphragm. Haemostasis was achieved and the patient recovered well post-operatively. This case highlights the importance of considering diaphragmatic rupture in the differential diagnosis of acute abdomen and haemorrhagic shock, especially in patients with ectopic pregnancy.Keywords: abdominal pregnancy, ectopic pregnancy, diaphragmatic pregnancy

The article describes a clinical case of ectopic pregnancy with localization in the liver. The patient Sh. was admitted to the gynecological department with pain in the lower abdomen and epigastrium. Clinical, laboratory and instrumental examinations were conducted in accordance with clinical recommendations. The examinations showed that human chorionic gonadotropin level was 17,440.85 mIU/ml. Pelvic ultrasound did not determine the fetal egg in the uterine cavity. However, free fluid in the pelvis (about 50 ml) was found. Repeated pelvic ultrasound revealed a paraovarial formation on the right, and free fluid in the pelvis. Laparoscopic surgery was performed, during which a fetal egg was found in the V segment of the liver. Liver resection and cholecystectomy were performed on an emergency basis. This case describes the importance of timely and correct diagnostics and determination of patient management tactics to prevent the development of life-threatening complications.

Abstract Background Abdominal pregnancy is a rare medical condition that is still missed in developing countries due to inadequate medical facilities. The clinical indicators manifest in various forms and are nonspecific, making it challenging to diagnose and often leading to delayed detection. However, obstetric ultrasound serves as an essential tool in early detection. Our objective was to share our experience dealing with this condition and emphasise the importance of early ultrasound diagnosis through efficient pregnancy monitoring in our regions. Case presentation 35-year-old Black African woman who had ten months of amenorrhea sought consultation due to an absence of active foetal movements. Her pregnancy was of 39 weeks with fetal demise which was confirmed following clinical examination and ultrasound. She underwent cesarean section in view of transverse position of fetus. During cesarean section, the fetus was found within the abdominal cavity with the placenta attached over the left iliac fossa including surface of left ovary. The uterus and right adnexa were within normal limits. A 2600 g macerated fetus with placenta and membranes were extracted without any complications. The maternal outcome was successful. Conclusions Abdominal pregnancy remained an inadequately diagnosed condition in developing countries. It is imperative to increase awareness among pregnant women regarding high-quality prenatal care, including early obstetric ultrasound, from conception. Meanwhile, healthcare professionals should receive continuous training and the technical platform modernised. To ensure accurate diagnosis, the location of the gestational sac must be identified for every pregnant woman during their initial ultrasound appointment.

Background: Abdominal pregnancy is a rare medical condition that is still missed in developing countries due to inadequate medical facilities. The clinical indicators manifest in various forms and are nonspecific, making it challenging to diagnose and often leading to delayed detection. However, obstetric ultrasound serves as an essential tool in early detection. Our objective was to share our experience dealing with this condition and emphasise the importance of early ultrasound diagnosis through efficient pregnancy monitoring in our regions. Case presentation: 35-year-old Black African woman who had ten months of amenorrhea sought consultation due to an absence of active foetal movements. Her pregnancy was of 39 weeks with fetal demise which was confirmed following clinical examination and ultrasound. She underwent cesarean section in view of transverse position of fetus. During cesarean section, the fetus was found within the abdominal cavity with the placenta attached over the left iliac fossa including surface of left ovary. The uterus and right adnexa were within normal limits. A 2600 g macerated fetus with placenta and membranes were extracted without any complications. The maternal outcome was successful. Conclusions: Abdominal pregnancy remained an inadequately diagnosed condition in developing countries. It is imperative to increase awareness among pregnant women regarding high-quality prenatal care, including early obstetric ultrasound, from conception. Meanwhile, healthcare professionals should receive continuous training and the technical platform modernised. To ensure accurate diagnosis, the location of the gestational sac must be identified for every pregnant woman during their initial ultrasound appointment. [ABSTRACT FROM AUTHOR]

Introduction: Pregnancy results in a lot of changes within the oral cavity, and recent reports have suggested an association between dental issues and poor pregnancy outcomes. Although many studies indicate that dental procedures can be carried out safely on pregnant patients to alleviate pain and promote better oral health, dental health is not given importance in pregnancy mainly due to fear and misconceptions that dental care can adversely affect the foetus. Aim: To summarise the dental presenting complaints and clinical examination findings of pregnant women and to evaluate the proportion of those compliant with the respective dental treatment services recommended by the dentist. Materials and Methods: It was a retrospective observational study analysing data pertaining to all pregnant patients who reported to the Department of Dentistry at Seth G.S. Medical College and King Edward Memorial Hospital in Maharashtra, India between December 2017 and September 2018. There was no formal sample size estimation, and all eligible patients’ data available in the department registry, which was maintained as part of routine clinical care, were analysed. A structured Case Record Form (CRF) was used to collect demographic and clinical data from these registers, and descriptive statistics were used to summarise the data. Results: The mean±Standard Deviation (SD) age of study sample was 27.69±4.584 years. A total of 81 patients’ data were included for the analysis. The most common presenting complaint and examination finding were pain and dental caries, respectively. The most common treatment plan suggested and performed was medication, followed by extraction. The number of patients who followed up was 37 (45.67%). Conclusion: Pain and carious tooth were the most common presenting complaint and examination finding, respectively. The proportion of patients who came for follow-up was not adequate, warranting enhanced awareness activities to reduce stigma over dental care during pregnancy.

Abdominal pregnancy is a very rare form of ectopic gestation in which implantation occurs in the peritoneal cavity. It accounts for about 1% of all ectopic pregnancies and is associated with a higher risk of morbidity and mortality due to complications such as preeclampsia, placenta abruption, and oligohydromnios, which necessitate pregnancy termination before term, and the risk of massive hemorrhage associated with abnormal placentation.We present a case of advanced abdominal ectopic pregnancy, diagnosed in the second trimester and complicated by anhydramnios. An abdominal ultrasound scan showed a nongravid uterus and a single live extrauterine fetus within the abdominal cavity, with no surrounding liquor at 23 weeks and 3 days average gestational age. Mother was consented and an emergency laparatomy performed. A premature baby was delivered but died in Neonatal Intensive Care Unit (NICU) after 4 hours due to severe acute respiratory distress syndrome. Mother had good postoperative recovery.Advanced abdominal ectopic pregnancy though very rare, is associated with complications that lead to early termination. Ultrasound scan is a reliable tool for the diagnosis of abdominal pregnancy in settings with limited access to Magnetic Resonance Imaging (MRI). It should be recommended to all mothers at their earliest antenatal care (ANC) visit to help determine the site of pregnancy and guide further intervention.

Abdominal pregnancy is a rare form of ectopic pregnancy (accounting for 1% of all ectopic pregnancies). Depending on gestational age and its location various symptoms and signs may be exhibited. This study aimed to report a case of abdominal pregnancy occurring in the Morrison Pouch with a primary presentation of right upper quadrant pain and to highlight complications that may arise in the management of abdominal pregnancy located in the Morrison Pouch. A 22-year pregnant woman at gestation of 22 weeks presented with a right upper quadrant mass and pain. Ultrasound examination revealed a live extrauterine singleton at Morrison Pouch, full blood count showed severe anemia. The patient received a blood transfusion in seven days and underwent emergency laparotomy after experiencing sudden acute internal hemorrhage but died a few hours post laparotomy due to hemorrhagic shock. Abdominal pregnancy carries a high risk of maternal hemorrhage as described in this case. [ABSTRACT FROM AUTHOR]

Copyright of Revista de la Facultad de Medicina Humana is the property of Instituto de Investigaciones en Ciencias Biomedicas de la Universidad Ricardo Palma and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Pregnancy results in a lot of changes within the oral cavity, and recent reports have suggested an association between dental issues and poor pregnancy outcomes. Although many studies indicate that dental procedures can be carried out safely on pregnant patients to alleviate pain and promote better oral health, dental health is not given importance in pregnancy mainly due to fear and misconceptions that dental care can adversely affect the foetus. Aim: To summarise the dental presenting complaints and clinical examination findings of pregnant women and to evaluate the proportion of those compliant with the respective dental treatment services recommended by the dentist. Materials and Methods: It was a retrospective observational study analysing data pertaining to all pregnant patients who reported to the Department of Dentistry at Seth G.S. Medical College and King Edward Memorial Hospital in Maharashtra, India between December 2017 and September 2018. There was no formal sample size estimation, and all eligible patients’ data available in the department registry, which was maintained as part of routine clinical care, were analysed. A structured Case Record Form (CRF) was used to collect demographic and clinical data from these registers, and descriptive statistics were used to summarise the data. Results: The mean±Standard Deviation (SD) age of study sample was 27.69±4.584 years. A total of 81 patients’ data were included for the analysis. The most common presenting complaint and examination finding were pain and dental caries, respectively. The most common treatment plan suggested and performed was medication, followed by extraction. The number of patients who followed up was 37 (45.67%). Conclusion: Pain and carious tooth were the most common presenting complaint and examination finding, respectively. The proportion of patients who came for follow-up was not adequate, warranting enhanced awareness activities to reduce stigma over dental care during pregnancy. [ABSTRACT FROM AUTHOR]

Abdominal pregnancy is a rare and life-threatening form of ectopic pregnancy. It is defined as an ectopic pregnancy in a region of the peritoneal cavity that does not include the fallopian tubes, ovaries, or their associated ligamentous structures. Many abdominal pregnancies are caused by secondary implantation in the peritoneal cavity after tubal abortion, rupture, or uterine rupture. Here, we report a case of abdominal pregnancy resulting from iatrogenic uterine perforation during the induced abortion of an early intrauterine pregnancy, which had been misdiagnosed as a ruptured corpus luteum cyst due to the sudden rupture of the abdominal gestational sac, complicating intra-abdominal hemorrhage. The true diagnosis was missed by vaginal ultrasound and confirmed by laparoscopic exploration. We discuss the details of the case management and review the relevant literature.

Abstract Background Abdominal pregnancy, a rare form of ectopic pregnancy, is associated with high morbidity and adverse consequences for future fertility. Early recognition and management reduce mortality and allow minimal invasive and conservative treatment. In modern medicine, primitive prevention to unexpected fatal pregnancies is crucial. Case presentation A divorced 33-year-old “self-identified” infertile polycystic ovary woman diagnosed as repeated implantation failure in previous in vitro fertilization with her ex-husband ever presented in surgery department with a history of 15-day abdominal pain, nausea, and vomiting and 3-h worsening abdominal pain. The serum beta-human chorionic gonadotropin value was more than 10,000 m-international units per milliliter. Sonogram findings were significant for the absence of intrauterine gestation; a placenta and well-formed living fetus of second-trimester gestation were seen in the abdomen, accompanied by hemoperitoneum. A unique spontaneously second-trimester tubo-abdominal pregnancy was confirmed in emergent laparotomy by gynecologists, she received a removing of the living fetus, a right total salpingectomy, resection of partial omentum and blood transfusion. The patient recovered uneventfully and her serum beta-human chorionic gonadotropin returned to normal range on the 30th postoperative day, till now, she has weak fertility awareness because of her catastrophic experiences in the unexpected abdominal pregnancy. Conclusions This case highlights woman with a previous in vitro fertilization history may be in is a high risk to be delayed or missed in diagnosis in an intended ectopic pregnancy due to a fixed belief in infertility. Educational interventions and contraceptive care should be provided by fertility and healthcare practitioner. The possibility of abdominal pregnancy must always be suspected and dealt with promptly and appropriately by the astute clinician.

Abstract Background Clinically silent uterine rupture with complete fetal expulsion into the abdominal cavity is an extremely rare complication. Diagnosis can be difficult and the risk to the mother and fetus is high. Conservative management has been described only in a few cases of partial expulsion of the fetus so far. Case presentation We present a case of 43-year-old tercigravida with a history of previous laparotomic myomectomy and subsequent cesarean section. The subsequent pregnancy was complicated by uterine wall loosening and rupture at the site of the previous uterine scar after myomectomy and complete fetal expulsion into the abdominal cavity. The diagnosis was made at 24 + 6 weeks of gestation. Considering the absence of clinical symptomatology and the good condition of the fetus, a conservative approach was chosen with intensive monitoring of the maternal and fetal conditions. The pregnancy ended by elective cesarean section and hysterectomy at 28 + 0 weeks of gestation. The postpartum course was uneventful and the newborn was discharged to home care 63 days after delivery. Conclusions Fetal expulsion into the abdominal cavity after silent uterine rupture of the scarred uterus may be accompanied by minimal symptomatology making early diagnosis difficult. This rare complication must be considered in the differential diagnosis in women after major uterine surgery. In selected cases and under conditions of intensive maternal and fetal monitoring, conservative management may be chosen to reduce the risks associated with prematurity.

Abstract Background Pregnancy begins with a fertilized ovum that normally attaches to the uterine endometrium. However, an ectopic pregnancy can occur when a fertilized egg implants and grows outside the uterine cavity. Tubal ectopic pregnancy is the most common type (over 95%), with ovarian, abdominal, cervical, broad ligament, and uterine cornual pregnancy being less common. As more cases of ectopic pregnancy are diagnosed and treated in the early stages, the survival rate and fertility retention significantly improve. However, complications of abdominal pregnancy can sometimes be life-threatening and have severe consequences. Case presentation We present a case of intraperitoneal ectopic pregnancy with fetal survival. Ultrasound and magnetic resonance imaging showed a right cornual pregnancy with a secondary abdominal pregnancy. In September 2021, we performed an emergency laparotomy, along with additional procedures such as transurethral ureteroscopy, double J-stent placement, abdominal fetal removal, placentectomy, repair of the right uterine horn, and pelvic adhesiolysis, in the 29th week of pregnancy. During laparotomy, we diagnosed abdominal pregnancy secondary to a rudimentary uterine horn. The mother and her baby were discharged eight days and 41 days, respectively, after surgery. Conclusions Abdominal pregnancy is a rare condition. The variable nature of ectopic pregnancy can cause delays in timely diagnosis, resulting in increased morbidity and mortality, especially in areas with inadequate medical and social services. A high index of suspicion, coupled with appropriate imaging studies, can help facilitate its diagnosis in any suspected case.

Abstract Background Rudimentary horn pregnancy is a rare life-threatening obstetric condition with clinical and sonographic presentation resembling that of an abdominal pregnancy. Preoperative diagnosis of advanced rudimentary horn pregnancy is difficult and cases are often identified incidentally during laparotomy for a presumed abdominal pregnancy. Case presentation We report a case of a 29-year-old African woman, gravida 2 para 1 at 28 weeks of gestation complaining of epigastric pain for 7 days with no other associated gastrointestinal or genitourinary symptoms. On examination, she had normal vital signs and an enlarged abdomen sized at 33 cm with unremarkable fetal lie and presentation. She had normal laboratory blood results with an ultrasound revealing an abdominal pregnancy of 28 weeks. The informed decision for conservative management was planned after informing of the benefit and risks of early termination versus conservative management, however, with worsening symptoms an emergency laparotomy had to be performed in which a left unruptured rudimentary horn pregnancy with a viable fetus was identified incidentally and delivery of the fetus followed by surgical excision of the horn was done. The postoperative period was uneventful, and the patient was discharged home with her newborn. Conclusion Rudimentary horn pregnancy is very rare and often indistinguishable from an abdominal pregnancy in advanced gestation age. First trimester ultrasound is by far the only noninvasive sensitive diagnostic modality for rudimentary horn pregnancy. Laparotomy with horn excision remains the standard of care for advanced rudimentary horn pregnancy.

Ectopic pregnancies are common in human medicine, while they are rarely recorded in animals. This report describes a case of 2.5-year-old ectopic primary abdominal pregnancy in a 7-year-old Persian cat. The cat was admitted to the surgery clinic for routine ovariohysterectomy with no characteristic clinical symptoms. During surgery, ovaries, uterus and ligaments were normal, like in a non-pregnant cat. Four intra-abdominal fetuses of different developmental stages were found and carefully removed. Three fetuses were found free in the abdomen inside their gestational sacs. The fourth fetus was covered with omentum and had no gestational sac. The gestational sacs had different sizes (2-8 cm in diameter). Two of the fetuses were fully-haired with normal position of limbs. No complications were recorded during the surgery and 10 months post-operative. This case report adds to the database of ectopic pregnancies in cats and further illustrates their incidental nature.

The abdominal wall is a rare site of ectopic implantation. Laparoscopic surgery for early abdominal pregnancy, in contrast to its use for tubal ectopic pregnancy, remains controversial because of concerns regarding heavy bleeding at the implantation site. Treatment of early abdominal pregnancy must be individualized for each implantation site. Herein, we present a case of an early abdominal pregnancy implanted in the anterior abdominal wall that was successfully treated with laparoscopic surgery. A 28‐year‐old multiparous woman with a 6‐week amenorrhea presented with acute abdominal pain. An ectopic pregnancy was suspected because of elevated serum human chorionic gonadotropin levels without a visible gestational sac on transvaginal ultrasonography. Diagnostic laparoscopy revealed a gestational sac hanging from the anterior abdominal wall near the previous cesarean section wound. Laparoscopic surgery was successfully performed, and the patient was discharged on postoperative day three. In the present case, laparoscopic surgery was beneficial. [ABSTRACT FROM AUTHOR]

Nontubal ectopic pregnancies occur as a result of embryo implantation outside the uterine cavity and fallopian tubes. Sites include ovary, cervix, abdominal cavity, interstitial portion of fallopian tube, and cesarean scar. Nontubal pregnancies are uncommon. Nonspecific signs and symptoms of nontubal ectopic pregnancies make diagnosis challenging and, in many cases, significantly delayed, resulting in a high rate of morbidity. Although surgical management remains the mainstay of treatment, there is growing evidence that some of these can be managed medically or with the use of a combination of medical and surgical approaches with good outcome. This review summarizes the current diagnostic modalities, therapeutic options, and outcomes for nontubal ectopic pregnancies. Diagnostic and management options may be limited, especially in resource-restricted settings. Therefore, an understanding of the available options is critical. It needs to be emphasized that the rarity of cases and the difficulties in organizing ethically justified randomized trials result in the lack of well-established management guidelines for nontubal ectopic pregnancies. [ABSTRACT FROM AUTHOR]

This paper presents the case of a 25-year-old patient who presented to the clinic with lower abdominal pain for several hours. On the basis of laboratory tests, history, and physical examination, a 5-week ectopic pregnancy was diagnosed, possibly located in the right fallopian tube. The patient was treated with a laparoscopic right salpingostomy. The immediate postoperative course was uneventful. The patient was discharged home with a recommendation to control the level of β human chorionic gonadotropin (β-hCG) in 7 days. After 2 weeks the patient returned to the clinic with symptoms of bleeding into the peritoneal cavity. A second laparoscopy with removal of the right fallopian tube and curettage of the uterine cavity were performed. Despite confirmation of the chorionic tissues by histopathology in the fallopian tube and the lack of confirmation of the chorionic tissues after the uterine cavity abrasion, the increased concentration of β--hCG and abdominal pain persisted after both procedures. Abdominal pregnancy was suspected, and a methotrexate single-dose therapy was initiated with satisfactory effect. The serum β--hCG concentration dropped by 29% after 4 days, and by 54% after 6 days, after 3 weeks the β--hCG level dropped to undetectable.

Tesfaye Kebede Legesse,1 Birhanu Abera Ayana,2 Semira Abrar Issa1 1Department of Radiology, Addis Ababa University, College of Health Science, Addis Ababa, Ethiopia; 2Department of Obstetrics and Gynecology, Addis Ababa University, College of Health Science, Addis Ababa, EthiopiaCorrespondence: Tesfaye Kebede Legesse, Tel +251911405854, Email Kebedetesfaye@yahoo.comBackground: Abdominal pregnancy refers to a rare form of ectopic pregnancy that has been implanted in the peritoneal cavity. Clinical suspicion combined with ultrasound is important for early diagnosis. A surviving fetus from an abdominal pregnancy is extremely rare.Case Presentation: Herein we report on a case of advanced abdominal pregnancy in a Gravida-III Abortion-II mother who presented with worsening abdominal pain of 1 week duration associated with fetal movement and managed successfully with an outcome of a live neonate and no maternal complication.Conclusion: A live neonate from term abdominal pregnancy is a rare occurrence. Early diagnosis of abdominal pregnancy is crucial to avoid potentially catastrophic maternal complications even though our patient, fortunately, has a smooth postoperative course. A high level of suspicion combined with ultrasound is helpful in reaching a diagnosis. Skill advancement for radiologists and non-radiology professionals involved in obstetric ultrasound is recommended to avoid misdiagnosis, as in our case. Careful post-operative evaluation is important to look for maternal and fetal complications.Keywords: abdominal pregnancy, ectopic, term, live neonate, Ethiopia

Background: Abdominal pregnancy, a rare form of ectopic pregnancy, is associated with high morbidity and adverse consequences for future fertility. Early recognition and management reduce mortality and allow minimal invasive and conservative treatment. In modern medicine, primitive prevention to unexpected fatal pregnancies is crucial. Case presentation: A divorced 33-year-old "self-identified" infertile polycystic ovary woman diagnosed as repeated implantation failure in previous in vitro fertilization with her ex-husband ever presented in surgery department with a history of 15-day abdominal pain, nausea, and vomiting and 3-h worsening abdominal pain. The serum beta-human chorionic gonadotropin value was more than 10,000 m-international units per milliliter. Sonogram findings were significant for the absence of intrauterine gestation; a placenta and well-formed living fetus of second-trimester gestation were seen in the abdomen, accompanied by hemoperitoneum. A unique spontaneously second-trimester tubo-abdominal pregnancy was confirmed in emergent laparotomy by gynecologists, she received a removing of the living fetus, a right total salpingectomy, resection of partial omentum and blood transfusion. The patient recovered uneventfully and her serum beta-human chorionic gonadotropin returned to normal range on the 30th postoperative day, till now, she has weak fertility awareness because of her catastrophic experiences in the unexpected abdominal pregnancy. Conclusions: This case highlights woman with a previous in vitro fertilization history may be in is a high risk to be delayed or missed in diagnosis in an intended ectopic pregnancy due to a fixed belief in infertility. Educational interventions and contraceptive care should be provided by fertility and healthcare practitioner. The possibility of abdominal pregnancy must always be suspected and dealt with promptly and appropriately by the astute clinician. [ABSTRACT FROM AUTHOR]

Copyright of Archives of Veterinary Medicine / Arhiv Veterinarske Medicine is the property of Scientific Veterinary Institute Novi Sad and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Pregnancy begins with a fertilized ovum that normally attaches to the uterine endometrium. However, an ectopic pregnancy can occur when a fertilized egg implants and grows outside the uterine cavity. Tubal ectopic pregnancy is the most common type (over 95%), with ovarian, abdominal, cervical, broad ligament, and uterine cornual pregnancy being less common. As more cases of ectopic pregnancy are diagnosed and treated in the early stages, the survival rate and fertility retention significantly improve. However, complications of abdominal pregnancy can sometimes be life-threatening and have severe consequences. Case presentation: We present a case of intraperitoneal ectopic pregnancy with fetal survival. Ultrasound and magnetic resonance imaging showed a right cornual pregnancy with a secondary abdominal pregnancy. In September 2021, we performed an emergency laparotomy, along with additional procedures such as transurethral ureteroscopy, double J-stent placement, abdominal fetal removal, placentectomy, repair of the right uterine horn, and pelvic adhesiolysis, in the 29th week of pregnancy. During laparotomy, we diagnosed abdominal pregnancy secondary to a rudimentary uterine horn. The mother and her baby were discharged eight days and 41 days, respectively, after surgery. Conclusions: Abdominal pregnancy is a rare condition. The variable nature of ectopic pregnancy can cause delays in timely diagnosis, resulting in increased morbidity and mortality, especially in areas with inadequate medical and social services. A high index of suspicion, coupled with appropriate imaging studies, can help facilitate its diagnosis in any suspected case. [ABSTRACT FROM AUTHOR]

Background: Rudimentary horn pregnancy is a rare life-threatening obstetric condition with clinical and sonographic presentation resembling that of an abdominal pregnancy. Preoperative diagnosis of advanced rudimentary horn pregnancy is difficult and cases are often identified incidentally during laparotomy for a presumed abdominal pregnancy. Case presentation: We report a case of a 29-year-old African woman, gravida 2 para 1 at 28 weeks of gestation complaining of epigastric pain for 7 days with no other associated gastrointestinal or genitourinary symptoms. On examination, she had normal vital signs and an enlarged abdomen sized at 33 cm with unremarkable fetal lie and presentation. She had normal laboratory blood results with an ultrasound revealing an abdominal pregnancy of 28 weeks. The informed decision for conservative management was planned after informing of the benefit and risks of early termination versus conservative management, however, with worsening symptoms an emergency laparotomy had to be performed in which a left unruptured rudimentary horn pregnancy with a viable fetus was identified incidentally and delivery of the fetus followed by surgical excision of the horn was done. The postoperative period was uneventful, and the patient was discharged home with her newborn. Conclusion: Rudimentary horn pregnancy is very rare and often indistinguishable from an abdominal pregnancy in advanced gestation age. First trimester ultrasound is by far the only noninvasive sensitive diagnostic modality for rudimentary horn pregnancy. Laparotomy with horn excision remains the standard of care for advanced rudimentary horn pregnancy. [ABSTRACT FROM AUTHOR]

Abdominal pregnancy is defined as pregnancy anywhere within the peritoneal cavity, exclusive of tubal, ovarian, or broad ligament locations. It is a rare form of ectopic pregnancy with high morbidity and mortality for both the mother and the fetus.Diagnosis can be frequently missed in low-resource settings because of poor antenatal healthcare provision, low socioeconomic patient status as well as lack of adequate medical resources. Clinical diagnosis can be difficult and ultrasound scan is helpful during the early stages of gestation but can be disappointing thereafter.A case of abdominal pregnancy in a 25-year-old woman, who presented at 26 weeks of gestation with severe abdominal pain not relieved by any medication, is reported. An emergency laparotomy was undertaken as her vital signs deteriorated. An abdominal pregnancy was found and a live neonate delivered.Ministries of health in developing countries should ensure routine access to ultrasound in early pregnancy. Obstetricians should bear in mind that abdominal pregnancy can present late in gestation.

Purpose: To analyze the clinical characteristics of abdominal pregnancy, and to explore the diagnosis and prognosis of different treatment methods. Methods: The cases of patients with abdominal pregnancy admitted to Peking Union Medical College Hospital between January 1, 1989 and January 1, 2021, were analyzed retrospectively. Results: The median age of 17 patients was 34 years (22–42 years); the median gestational duration was 57 days (from 41 days to 32 weeks). Among all 17 patients, 15 (88.24%) presented with abdominal pain. The implantation sites of the gestational sac included the bladder peritoneal reflection, anterior wall of the rectum, omentum, serous membrane of the uterus, and inside or on the surface of uterosacral ligament. In all, only 29.41% cases (5/17) were diagnosed before surgery. All 17 patients were treated via surgery. Further, 58.82% (10/17) patients recovered without complications, 29.41% (5/17) developed fever, 5.88% (1/17) underwent reoperation because of intra-abdominal bleeding, and 5.88% (1/17) developed double lower limb venous thrombosis. All 17 patients survived. Conclusion: The preoperative diagnosis rate of abdominal pregnancy is low. Planting sites in the pelvic peritoneum and pelvic organs are more common than the others. Laparoscopic surgery in the first trimester of pregnancy can achieve better therapeutic effects. However, the blood supply of the placenta should be fully evaluated before surgery. When it is expected that attempts to remove the placenta will cause fatal bleeding, the placenta can be left in place, but long-term close follow-up should be paid attention to. [ABSTRACT FROM AUTHOR]

A 25‐year‐old woman presented to the emergency department with acute abdominal pain and amenorrhea. The vaginal ultrasound showed a right para‐adnexal mass with a living embryo. An abdominal pregnancy on the ascending colon was found in the laparotomy. The management included removing the gestational sac and treatment with methotrexate. [ABSTRACT FROM AUTHOR]

Abstract Background The term heterotopic pregnancy is defined as a uterine pregnancy coexisting with a second pregnancy in an extrauterine location. Spontaneous, full-term heterotopic pregnancy with alive birth is very rare. The diagnosis and management of such exceptionally unique case is difficult. When the patient presented with an advanced labor with no antenatal care follow up and with no risk factors is even more challenging for poorly equipped facilities like ours. Case presentation A 25 years old gravida 3, para 2 (both are alive) mother presented to the labor and delivery ward of Bele Primary Hospital, Southern Ethiopia with the complaint of pushing down pain of 18 h duration. Immediately after arrival, she gave birth to a 3300gm female neonate spontaneously. After delivery, an abdominal mass was recognized and manual exploration of the uterus was done to look for the presence of after coming second twin but the uterus was empty. On ultrasound examination, there was an alive fetus in transverse lie outside the uterus. With the impression of 2nd twin in a separate horn of bicornuate uterus and to rule out abdominal pregnancy, laparotomy was done. On laparotomy, there was abdominal pregnancy in the Pouch of Douglas with an intact amniotic sac. The sac was attached with the left broad ligament, left ovary, small bowel mesentery, and posterior wall of the uterus. The sac opened, a 1600gm alive female neonate with features of fetal growth restriction and left club foot was delivered. The placenta was detached spontaneously and removed without any complication. Conclusions The coexistence of spontaneous full-term intrauterine with advanced abdominal ectopic pregnancy is one of the rarest forms of heterotopic pregnancy. Every health professional should bear in mind that intrauterine and extrauterine pregnancy may happen simultaneously and it can progress to term without any symptoms. Ultrasound is the diagnostic method of choice but the existence of an intra-uterine pregnancy cannot rule out ectopic pregnancy. The life-threatening complication of abdominal ectopic pregnancy is bleeding from the detached placental site. Therefore, the decision to remove the placenta should be individualized.

Abdominal ectopic pregnancy (AEP) occurs within the peritoneal cavity, outside the genital organs (uterus, tubes, ovaries). It is an unusual condition with an incidence that varies from 1:10,000 to 1:30,000 of all pregnancies worldwide. A 38-year-old primigravid patient was diagnosed in the second trimester with AEP. Pregnancy reached 35.6 gestational weeks, and the patient underwent surgery via laparotomy for extraction of the live fetus. Complete removal of the placenta was performed without maternal or fetal complications. AEP is an important cause of maternal and fetal death; the mortality rate in pregnant women with AEP is approximately 1–18%. Surgical intervention to deliver a baby in cases of AEP requires a multidisciplinary team, especially in countries with limited therapeutic options.

Abdominal pregnancy is defined as one that occurs outside of the uterus and fallopian tubes in the abdominal cavity. We present the case of a 30-year-old Peruvian female patient from Lima with a surgical history of exploratory laparotomy due to tubal ectopic pregnancy and appendectomy without further relevant personal or family histories. She attended the emergency room of a social security hospital in Peru with a referral from a district hospital and a diagnosis of abdominal pregnancy at 14 weeks of gestational age without previous prenatal controls. Symptomatology at hospital admission was colic-type abdominal pain in the hypogastrium without vaginal bleeding, fluid loss or fever. During hospitalization, she underwent an exploratory laparotomy with embolization of the uterine artery, left salpingectomy, and removal of the abdominal ectopic pregnancy. The evolution was favorable after the surgery, and she was discharged. Without further complications, she continues her controls at the obstetrics and gynecology outpatient service without complications.

Abdominal Ectopic Pregnancy (AEP), a rare life-threatening obstetrical complication, is defined as ectopic implantation within the peritoneal cavity outside the uterus, tubes, ovaries, or intra-ligamentous locations. A series of three rare cases of early AEP is presented: (First case: a 32-year-old, gravida 2, para 1; Second case: a 31-year-old, gravida 3, para 2; and Third case: a 39-year-old gravida 4, para 2). All the cases were of early (

Abstract A 25‐year‐old woman presented to the emergency department with acute abdominal pain and amenorrhea. The vaginal ultrasound showed a right para‐adnexal mass with a living embryo. An abdominal pregnancy on the ascending colon was found in the laparotomy. The management included removing the gestational sac and treatment with methotrexate.

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Heterotopic pregnancy after bilateral salpingectomy is an extremely rare complication of in vitro fertilisation/embryo transfer cycles. We report a case of a ruptured abdominal pregnancy on the omentum which was the stimulus to conduct the first systematic review on this complication according to 'PRISMA' guidelines (PROSPERO R.No CRD42020134104). PubMed, EMBASE and OpenAIRE databases were systematically reviewed for studies reporting (a) cases or case series of, (b) heterotopic pregnancies after, (c) prior bilateral salpingectomy, and (d) embryo transfer cycles. Twenty-two articles met the selection criteria including, with our case, 28 cases. Based on the results, clinical manifestations and laboratory findings can be unspecific or misleading. Transvaginal ultrasound is the main diagnostic tool as the ectopic foetus is more frequently located in the intramural part of the fallopian tubes, the tubal stump or the ovaries. Laparotomy or laparoscopy are the main treatment options with adequate perinatal outcome. [ABSTRACT FROM AUTHOR]

Abdominal pregnancy is a rare condition that may cause a significant threat to maternal life. This kind of pregnancy is the most-uncommon kind of ectopic pregnancy. It can cause significant morbidity because of its impact on vital organs to ability to reach an advanced gestational age if not promptly diagnosed and managed. Abdominal pregnancy occurs when a fertilized ovum implants within the abdomen but outside the female reproductive organs, either primarily, or as a result of tubal or uterine rupture, or after a procedure. Abdominal pregnancy may be diagnosed incidentally on first-trimester sonography or after a patient presents with abdominal pain or bleeding. The gestational age at presentation varies based on symptoms, location of implantation, and ability of the patient to access care. Treatment is most often surgical, but image-guided vessel embolization or direct injection of methotrexate may also be used in certain clinical situations. Successful treatment often requires a multidisciplinary approach and careful preoperative planning. (J GYNECOL SURG 38:193) [ABSTRACT FROM AUTHOR]

Abdominal pregnancy is a rare and potentially fatal variant of ectopic pregnancy, presenting unique clinical challenges. This report discusses an unusual case of abdominal pregnancy associated with uterine and high rectal perforations, complications that are rarely reported in clinical practice. We report a case involving a 31-year-old woman from a rural area, with a psychiatric history, presenting severe abdominal pain, vomiting, and constipation. Initial investigations revealed a hemopneumoperitoneum and a fetal skeleton in the pelvic area by CT, leading to a diagnosis of abdominal pregnancy. Surgical findings included a nonviable fetus, approximately 5 months gestational age, and perforations in both the rectum and the posterior uterine wall. The patient underwent extensive surgery, including placental dissection, anterior rectal resection, Hartmann's colostomy, hysterorrhaphy, and drainage of the peritoneal cavity. The complexity of managing abdominal pregnancy, especially with additional complications such as organ perforations, poses significant surgical challenges. This case emphasizes the need to consider abdominal pregnancy in differential diagnoses of abdominal pain in women, due to the risk of misdiagnosis and complex surgical requirements. This case highlights the critical importance of prompt diagnosis and comprehensive care in managing rare and life-threatening presentations of abdominal pregnancy. It underscores the need to increase awareness among clinicians for timely intervention and provides information on the complexities of surgical management in cases with additional organ perforations. • Rare case of abdominal ectopic pregnancy with concurrent uterine and high rectal perforations • Successful management of a complex surgical scenario in a patient with psychiatric history • Utilization of advanced imaging for accurate diagnosis of an intricate abdominal pregnancy • Comprehensive surgical intervention including placental dissection, anterior rectal resection, and Hartmann's colostomy • Highlights the need for differential diagnosis awareness and surgical adaptability in rare ectopic pregnancies [ABSTRACT FROM AUTHOR]

Abdominal pregnancy is an extremely rare form of ectopic gestation, and it presents with pelvic pain, severe bleeding, or remain asymptomatic. Its Risk factors include previous ectopic pregnancies, cesarean section, smoking, pelvic inflammatory disease, using intrauterine devices (IUD), and assisted reproductive techniques (ARTs). Accurate diagnosis of rectal ectopic pregnancy remains challenging due to the lack of well-established diagnostic criteria. A 25-year-old woman presented to the emergency department with a 2-day history of unresponsive lower abdominal pain and nausea. Ultrasound imaging revealed a normal-sized uterus with endometrial thickness, fluids, and clots in the abdominal cavity, but no intrauterine gestational sac was detected. Based on the clinical presentation, ectopic pregnancy was suspected. During laparotomy, the placenta and fetal tissue remnants were found on the anterior wall of the upper third of the rectum. Abdominal ectopic pregnancy is a high-risk condition that can manifest with gastrointestinal symptoms such as nausea, vomiting, constipation, as well as abdominal and pelvic pain. These variable symptoms underscore the importance of considering rectal ectopic pregnancy as a differential diagnosis and ruling it out to prevent life-threatening complications, including severe bleeding. Due to its rarity, diverse presentation, and similarity to other conditions, diagnosing rectal ectopic pregnancy and determining the appropriate management can be challenging. Physicians should be aware of this specific type of ectopic pregnancy to enable early-stage diagnosis and provide optimal care. • Rare case of rectal ectopic pregnancy • Diagnosing rectal ectopic pregnancy remains challenging due to the lack of well-established diagnostic criteria. • Awareness and suspicion are crucial for the diagnosis of rectal ectopic pregnancy. • Early-stage diagnosis and optimal care are essential for managing rectal ectopic pregnancy effectively. [ABSTRACT FROM AUTHOR]

Background: The term heterotopic pregnancy is defined as a uterine pregnancy coexisting with a second pregnancy in an extrauterine location. Spontaneous, full-term heterotopic pregnancy with alive birth is very rare. The diagnosis and management of such exceptionally unique case is difficult. When the patient presented with an advanced labor with no antenatal care follow up and with no risk factors is even more challenging for poorly equipped facilities like ours.Case Presentation: A 25 years old gravida 3, para 2 (both are alive) mother presented to the labor and delivery ward of Bele Primary Hospital, Southern Ethiopia with the complaint of pushing down pain of 18 h duration. Immediately after arrival, she gave birth to a 3300gm female neonate spontaneously. After delivery, an abdominal mass was recognized and manual exploration of the uterus was done to look for the presence of after coming second twin but the uterus was empty. On ultrasound examination, there was an alive fetus in transverse lie outside the uterus. With the impression of 2nd twin in a separate horn of bicornuate uterus and to rule out abdominal pregnancy, laparotomy was done. On laparotomy, there was abdominal pregnancy in the Pouch of Douglas with an intact amniotic sac. The sac was attached with the left broad ligament, left ovary, small bowel mesentery, and posterior wall of the uterus. The sac opened, a 1600gm alive female neonate with features of fetal growth restriction and left club foot was delivered. The placenta was detached spontaneously and removed without any complication.Conclusions: The coexistence of spontaneous full-term intrauterine with advanced abdominal ectopic pregnancy is one of the rarest forms of heterotopic pregnancy. Every health professional should bear in mind that intrauterine and extrauterine pregnancy may happen simultaneously and it can progress to term without any symptoms. Ultrasound is the diagnostic method of choice but the existence of an intra-uterine pregnancy cannot rule out ectopic pregnancy. The life-threatening complication of abdominal ectopic pregnancy is bleeding from the detached placental site. Therefore, the decision to remove the placenta should be individualized. [ABSTRACT FROM AUTHOR]

Abdominal pregnancy is a very rare form of ectopic pregnancy and is associated with an increased mortality rate. The main lifethreating complication is intraperitoneal bleeding from placental site. The gestational age is important for the prediction of complications’ severity. While most cases are secondary to a tubal rupture and the subsequently implantation in the peritoneal cavity, a previous uterine perforation can also represent the leading cause. In the current paper, we report an extremely rare case of secondary abdominal pregnancy with a gestational age of 11 weeks in a 37year old patient having a history of unnoticed uterine perforation. This report raises awareness on a rare and severe obstetrical condition, discussing the case particularities, with the aim to highlight the urge for prompt diagnostic and treatment measures. [ABSTRACT FROM AUTHOR]

We present a case of spontaneous pregnancy after laparoscopic surgery for a broad ligament pregnancy. A 34‐year‐old nulliparous woman presented with 6 weeks of amenorrhea. Due to the presence of an empty uterus with a 10 mm right adnexal mass on transvaginal ultrasonography and elevated serum human chorionic gonadotropin (hCG), ectopic pregnancy was suspected. Upon diagnostic laparoscopy, the presence of a 2 cm broad ligament ectopic pregnancy was confirmed. Laparoscopic removal of the gestational tissues was performed. Six months after surgery, a spontaneous pregnancy was established. At the 40th week of gestation, a cesarean section was performed due to arrested labor, resulting in live birth. To the best of our knowledge, there have been no reports of a spontaneous pregnancy occurring after laparoscopic surgery for broad ligament pregnancy. Laparoscopic surgery as a treatment option for broad ligament pregnancy may be useful in early gestational age because it can be completed without complications. [ABSTRACT FROM AUTHOR]

Spontaneous heterotopic pregnancy is a potentially life-threatening condition rarely considered when a patient with an intrauterine pregnancy is asymptomatic or presents with complaints such as abdominal pain. An advanced abdominal pregnancy is even more unusual as the form of the ectopic component outside the context of assisted reproduction and is difficult in diagnosis with very few cases reported in the literature. We report such a case in a 31-year-old primigravida with heterotopic pregnancy which is a fetus in the uterine cavity and the other in the abdominal cavity. Her pregnancy was initially misdiagnosed and managed as a di-amniotic di-chorionic gestation. The correct diagnosis was only made after term delivery of the intrauterine pregnancy. The patient was complicated with severe bleeding which led to disseminated intravascular coagulopathy and massive transfusion. Two other operations were imposed on the patient because of bleeding. The clinical risk factor for ectopic pregnancy was only previous pelvic inflammatory disease in this woman.

The development to term of a pregnancy attached into the abdominal cavity is a rare finding and is associated with an increased risk of maternal and fetal morbidity and mortality. We present a case where an abdominal pregnancy was first discovered at the time of a planned caesarean section for suspected major placenta praevia and transverse lie. After the fetal extraction (2750 grams, Apgar score 6 and 8 at 1 and 5 minutes), the placenta was seen inserted onto the root of the mesentery, the sigmoid colon and mesosigmoid and on the fundus of the uterus. The decision was to leave the placenta in situ after the ligation of the umbilical cord. The postoperative course was uneventful. A magnetic resonance imaging was performed during the hospital stay and three months later, showing the involution of placenta. No complications were recorded during two years of follow- up. When an abdominal pregnancy is unexpectedly encountered at term, the placenta can be left in situ in order to avoid uncontrolled hemorrhage and unwanted lesions to the abdominal organs to which placenta is attached; a planned second stage surgery can then be taken into consideration for its removal in case of complications. In our case, a conservative management was adopted, with close clinical and imaging (MRI, abdominal ultrasound) follow-up and the patient had an uneventful recovery with a gradual involution of the placenta. [ABSTRACT FROM AUTHOR]

Abdominal pregnancies are a rare form of ectopic pregnancy with omentum pregnancies being even rarer. Ectopic pregnancy should be diagnosed and terminated early to prevent the risk of harm to the mother. This case report describes a rare case of omentum pregnancy with severe hemoperitoneum. The patient had not visited a doctor until she failed to menstruate for 3 months, by which point she had developed severe hypogastralgia. The patient was diagnosed with a ruptured ectopic pregnancy after ultrasonography. The omentum pregnancy was complicated by severe hemoperitoneum, which was confirmed by emergency laparotomy. The patient was treated successfully with fetal extraction and partial omentectomy. Ultrasound examination in early pregnancy is essential to detect and treat ectopic pregnancies as early as possible, as surgery is usually required for abdominal pregnancies. Prompt treatment of ectopic pregnancies is critical, as an omentum pregnancy is dangerous and may result in severe intraperitoneal bleeding., Competing Interests: Declaration of conflicting interestThe authors declare that there are no conflicts of interest.

Objectives: Purpose of this narrative review is to compare, the latest findings about ectopic pregnancy (EP) reporting pathogenetic hypothesis, common and uncommon symptoms, diagnostic work-up, treatment alternatives. EP is a pathological condition characterized by an abnormal blastocyst implant at any site apart from uterine cavity. Dealing with pathogenesis we can recognize many factors: hormonal imbalance, post infective or mechanical induced defects of the tube, assisted reproduction techniques. This condition has aroused interest for its capacity to evolve instantly in a life-threatening condition, needing an early diagnosis and an urgent surgical solution. Mechanism: A comprehensive literature research of recent articles has been performed. Researches for relevant data were conducted utilizing multiple databases, including PubMed, SCOPUS and Ovid. Searches included combinations of the key terms: tubal pregnancy, cervical pregnancy, cesarean scar pregnancy, ‘twin and ectopic pregnancy’, ‘twin and tubal pregnancy’, ‘twin heterotopic pregnancy’, ‘laparoscopy and twin pregnancy’, ‘laparoscopy and tubal pregnancy’, ‘surgery and pregnancy’, ‘surgery and ectopic’, ‘surgery and twin tubal pregnancy’, “methotrexate and twin pregnancy ‘cornual pregnancy’ ”. Findings in brief: EP is frequently located in the salpinges but may also occur in many other sites like uterine horns, cervix, ovaries, cesarean scar or in splanchnic organs. Typical signs and symptoms of EP usually consist of pelvic pain, vaginal bleeding or sudden amenorrhea. Beta-human chorionic gonadotropin (b-hCG) dosages are fundamental tools for diagnosis of the early pregnancy whether is normal or not, always considering tubal pregnancy a possible event. Imaging diagnostic tools are described in our review, Ultrasound, Magnetic resonance imaging (MRI), Computed Tomography (CT) are the main options. When the serum b-hCG is positive but at ultrasound examination of pregnancy cannot be found, physician must define this condition as a pregnancy of unknown location (PUL). In this literature-based review we found three therapeutic solutions: expectant, medical or surgical management. Expectant strategy consists of strictly monitoring b-hCG values with no pharmacological or surgical intervention. Methotrexate administration following therapeutic schemes is a cost-effective solution and keeps patient away from surgical risks. Surgery maintains a key role in treatment choice considering that is the only one available in emergency scenario. Conclusions: EP is a diagnostic challenge for the physician, therapy choice is a careful and difficult decision that must be always individualized to ensure patient life uppermost and also future fertility desire.