PDF(Pubmed)
Abstract：
BACKGROUND Abdominal pregnancy is a rare form of extrauterine pregnancy that usually results in a poor outcome; it is associated with serious fetal and maternal morbidity. The diagnosis of advanced abdominal pregnancy is sometimes challenging and should be identified early, at a routine antenatal examination. There are still no evidence-based management strategies for late abdominal pregnancy. This report presents a case of a patient with an abdominal pregnancy and a non-viable fetus. CASE REPORT A 34-year-old woman presented as an emergency 2 months after the diagnosis of intrauterine fetal death at 33 weeks of gestation. During subsequent surgery, the pregnancy was found to be an undiagnosed abdominal pregnancy. The patient had been admitted due to abdominal pain and increasingly deteriorating general condition. On admission, clinical examination and abdominal ultrasound were carried out and the diagnosis of fetal death was confirmed. The diagnosis of extrauterine pregnancy, however, was initially missed, and a decision to induce labor was made. After unsuccessful induction of labor and deterioration of the patient\'s general condition, a laparotomy was performed, and the diagnosis of abdominal pregnancy was confirmed. A severely macerated fetus and placenta were delivered. Relative to others with this condition, the patient had a very good postoperative outcome with prolonged healing of the surgical incision. Informed consent for publication was obtained from the patient. CONCLUSIONS The diagnosis of late abdominal pregnancy can be missed despite clinical and sonographic examination. This diagnosis should be considered and excluded in similar suspected clinical findings. Proper operative planning in a tertiary center with a well-experienced team is crucial.
摘要：
背景技术腹部妊娠是一种罕见的宫外妊娠形式,通常导致不良结局;它与严重的胎儿和母体发病率相关。晚期腹腔妊娠的诊断有时具有挑战性，应及早发现，例行产前检查.目前仍没有针对晚期腹腔妊娠的循证管理策略。本报告介绍了一例腹部妊娠和胎儿无法存活的患者。病例报告一名34岁女性在妊娠33周时诊断为宫内胎儿死亡2个月后出现紧急情况。在随后的手术中,发现怀孕是未诊断的腹部怀孕。患者因腹痛和全身状况日益恶化而入院。一入场,进行临床检查和腹部超声检查，确诊为胎儿死亡。宫外孕的诊断，然而,最初错过了，并做出了引产的决定。引产失败后，患者的一般状况恶化，进行了剖腹手术,并确诊为腹腔妊娠。分娩了严重浸软的胎儿和胎盘。相对于其他有这种情况的人，患者术后效果非常好,手术切口愈合时间延长.从患者获得公开的知情同意书。结论尽管进行了临床和超声检查，但仍可能错过晚期腹腔妊娠的诊断。在类似的可疑临床发现中，应考虑并排除此诊断。在拥有经验丰富的团队的三级中心进行适当的手术计划至关重要。
