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Am J Obstet Gynecol. 2008 Mar;198(3):297.e1-7. doi: 10.1016/j.ajog.2007.09.044.

Advanced extrauterine pregnancy: diagnostic and therapeutic challenges.

Author information

1
Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX 75390-9032, USA. kworle@parknet.pmh.org

Abstract

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.

PMID:
18313451
DOI:
10.1016/j.ajog.2007.09.044
[Indexed for MEDLINE]

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