Hemoperitoneum during removal of the placenta in advanced abdominal pregnancy with live fetus delivered at 37 weeks of gestation. A case report in a low-resource setting and literature review
| Autor: | Mimico Mulemangabo, Paola Caravaggi, Mirko Muroni, Joel Nkurunziza, Jean Marie Vianney Butoyi, Mwajuma Shimirimana |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Abdominal pain Ectopic pregnancy medicine.medical_treatment Placenta Case Report 03 medical and health sciences 0302 clinical medicine Laparotomy medicine Vaginal bleeding Hemoperitoneum reproductive and urinary physiology Fetus Case reports Obstetrics business.industry medicine.disease medicine.anatomical_structure 030220 oncology & carcinogenesis embryonic structures Abdominal pregnancy 030211 gastroenterology & hepatology Surgery medicine.symptom Advanced abdominal pregnancy business |
| Zdroj: | International Journal of Surgery Case Reports |
| ISSN: | 2210-2612 |
| Popis: | Highlights • In advanced abdominal pregnancy, even in a low-resource setting, the fetus may survive. • Our report is first report from Burundi about newborn survival in advanced abdominal pregnancy. • Bleeding from placenta removal can become a life-threatening surgical complication. • To leave the placenta in situ after removal of the fetus, may be a safe option. Introduction and importance Advanced abdominal pregnancy (> 20 weeks gestation) is a rare condition life-threatening for mother and fetus. Case presentation A 31-years-old African woman presented from a rural district to Mutoyi Hospital for first gynecological evaluation after 37 weeks of amenorrhea, abdominal pain and vaginal bleeding. An ultrasound revealed an extra-uterine fetus. Laparotomy was done and a live fetus weighing 1980 g was delivered. Removal of the placenta, triggered massive bleeding (5000 mL) with shock. After re-laparotomy for post-operative ileus and hemoperitoneum, the mother and infant were discharged in good health. Clinical discussion Viable fetus can be delivered after an advanced abdominal pregnancy. Removal of the placenta is controversial. We review currently medical literature on advanced abdominal pregnancy and propose a management of the placenta in these patients. Conclusion We recommended to leave the placenta in situ, to avoid intraoperative bleeding. Placenta involution during follow-up can be revealed by ultrasound, colordoppler and β-hCG serum level decrease. |
| Databáze: | OpenAIRE |
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