TY - JOUR
T1 - Advanced extrauterine pregnancy
T2 - diagnostic and therapeutic challenges
AU - Worley, Kevin C.
AU - Hnat, Michael D.
AU - Cunningham, F. Gary
PY - 2008/3
Y1 - 2008/3
N2 - Objective: The objective of the study was to identify women with advanced extrauterine pregnancy, specifically assessing the problems encountered with their diagnosis and management, preoperative evaluation, and surgical removal. Study Design: This was a case series including women diagnosed with an extrauterine pregnancy of 18 weeks' gestation or greater at our institution from 1980 to 2005. Results: We identified 10 women with advanced extrauterine pregnancies during the study period. Diagnosis was not optimal, and only 6 were discovered preoperatively. Despite the fact that only 3 of 10 women met diagnostic criteria for an abdominal pregnancy, surgical dissection was universally difficult, and hemorrhage was common with 9 of 10 patients requiring blood transfusions. In 2 women, the placenta was left in situ, and both developed serious complications. All 5 viable fetuses survived, but their courses were long and complicated. Conclusion: Irrespective of placental implantation site, an advanced extrauterine pregnancy is a serious condition. The currently accepted definition of abdominal pregnancy is too exclusive.
AB - Objective: The objective of the study was to identify women with advanced extrauterine pregnancy, specifically assessing the problems encountered with their diagnosis and management, preoperative evaluation, and surgical removal. Study Design: This was a case series including women diagnosed with an extrauterine pregnancy of 18 weeks' gestation or greater at our institution from 1980 to 2005. Results: We identified 10 women with advanced extrauterine pregnancies during the study period. Diagnosis was not optimal, and only 6 were discovered preoperatively. Despite the fact that only 3 of 10 women met diagnostic criteria for an abdominal pregnancy, surgical dissection was universally difficult, and hemorrhage was common with 9 of 10 patients requiring blood transfusions. In 2 women, the placenta was left in situ, and both developed serious complications. All 5 viable fetuses survived, but their courses were long and complicated. Conclusion: Irrespective of placental implantation site, an advanced extrauterine pregnancy is a serious condition. The currently accepted definition of abdominal pregnancy is too exclusive.
KW - abdominal pregnancy
KW - advanced ectopic pregnancy
KW - advanced extrauterine pregnancy
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U2 - 10.1016/j.ajog.2007.09.044
DO - 10.1016/j.ajog.2007.09.044
M3 - Article
C2 - 18313451
AN - SCOPUS:39649102949
SN - 0002-9378
VL - 198
SP - 297.e1-297.e7
JO - American journal of obstetrics and gynecology
JF - American journal of obstetrics and gynecology
IS - 3
ER -