Second Trimester Abdominal Pregnancy With An Unusual Presentation Of Umbilical Bleeding And Management In A Resource Limited Set Up- A Case Report
Chidinma Nwogu
Kingswill specialist hospital, Lagos
Keywords: Abdominal pregnancy, Second trimester, Umbilical bleeding
Abstract
Abdominal or intra-abdominal pregnancy is rare, making up 1% of all ectopic gestations. It can result in life threatening maternal complications such as massive bleeding from placental separation, abscess formation and coagulopathy which can complicates excessive bleeding, fetal demise or sepsis. It is often misdiagnosed in the early stage leading to late diagnosis and in such cases the fetal outcome is worse with very high perinatal mortality leaving majority of the surviving infants with serious malformations. Clinical features are usually vague. Early ultrasonography in pregnancy has made early diagnosis easier. The rarity of advanced abdominal pregnancy with a high misdiagnosis rate and non specificity of the specific clinical signs and symptoms explain the lack of standardized diagnostic and treatment protocols. A case of abdominal pregnancy with at 16 weeks is described with an unusual presentation of umbilical bleeding with its management in a resource limited set-up.