Autor: |
Rostirolla GF; Department of Obstetrics and Gynecology, Hospital General, Caxias do Sul, RS, Brazil.; Department of Medicine, University of Caxias do Sul, Caxias do Sul, RS, Brazil., Grossi FS; Department of Obstetrics and Gynecology, Hospital General, Caxias do Sul, RS, Brazil., Dos Santos FM; Department of Oncological Surgery, Hospital General, Caxias do Sul, RS, Brazil., Lain VV; Department of Medicine, University of Caxias do Sul, Caxias do Sul, RS, Brazil.; Department of Vacular Surgery, Hospital General, Caxias do Sul, RS, Brazil., Loss LB; Department of Urology, Hospital General, Caxias do Sul, RS, Brazil., Angeletti MG; Department of Anesthesiology, University of Caxias do Sul, Caxias do Sul, RS, Brazil.; Department of Anesthesiology, CAN Anesthesiology Clinic, Caxias do Sul, RS, Brazil., De Stefani ZF; Department of Anesthesiology, CAN Anesthesiology Clinic, Caxias do Sul, RS, Brazil., Zampieri MC; Department of Obstetrics and Gynecology, Hospital General, Caxias do Sul, RS, Brazil., Vedana M; Department of Obstetrics and Gynecology, Hospital General, Caxias do Sul, RS, Brazil., Vettorazzi J; Department of Obstetrics and Gynecology, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil. |
Abstrakt: |
BACKGROUND Abdominal pregnancy is a special type of ectopic pregnancy, characterized by implantation of the embryo in the peritoneal cavity, with tubal, ovarian, and intraligamentary pregnancies excluded, accounting for approximately 1% of all cases. It was first reported in 1708 after an autopsy and since then numerous cases have been reported, with a current incidence of 1: 10 000 to 1: 30 000 pregnancies. CASE REPORT We report the case of a 27-year-old woman, resident of the city of Caxias do Sul, Brazil, with an extra-uterine pregnancy by ultrasound diagnosis at 25 weeks and 1 day of gestational age and a live fetus. CONCLUSIONS Abdominal gestation is a rare type of ectopic pregnancy and is characterized as a life-threatening situation. Its biggest challenge is to make an early diagnosis, since most cases go unnoticed at the ultrasound performed in the first trimester, and when symptomatic, they do not present themselves in a specific way. When necessary, MRI has been shown to greatly elucidate such cases. Moreover, the therapeutic decision also presents some disparities in the literature. Although it is known that open surgery is best option, there are still many doubts regarding whether to perform placental extraction since its removal process can cause abundant bleeding, putting the patient at risk during the surgical procedure, in the same way that its maintenance and the use of drug treatment can also aggravate the patient's clinical picture. |