Abdominal Pregnancy: 1 Case Report and Review of the Literature

Abdominal pregnancies account for less than 1% of all ectopic pregnancies, with a maternal mortality rate that remains eight times higher than for tubal pregnancies. Two types of abdominal pregnancy can occur: primary intra-peritoneal and secondary: expulsion into the abdomen of a pregnancy initiated in a uterine tube (tubo-abdominal abortion). Several risk factors described in the literature are at the origin of ectopic pregnancies, including genital infections in the first instance, infertility as well as intra-uterine device and IVF. In addition to targeted 1st trimester ultrasonography, the deployment of MRI enables us to improve diagnosis and assess the degree of placental adhesion. As for clinical assessment of the parturient, clinical features to look for in an abdominal pregnancy include easy palpation of the fetal parts, abdominal tenderness, atypical fetal presentation and decreased uterine height (IUGR or decreased amniotic fluid). Abdominal pregnancy always carries a high risk of maternal morbidity and mortality, the most dreaded complication being haemorrhage. Nevertheless, the decision to remove the placenta or leave it in situ must be considered on a case-by-case basis, after evaluation of the implantation site. In both cases, the placenta has been completely removed, with hemostasis assured, which justifies the need for no further treatment.