Term Abdominal Pregnancy Revealed by Amnioperitoneum in Rural Area

Abstract EN

Abdominal pregnancy (AP) accounts for 1% of ectopic implantations.

In sub-Saharan Africa, the high prevalence of sexually transmitted infections explains the increasing frequency of this pathology.

In Cameroon it rose from 1/10000 deliveries (1995) to 3.3/10000 (2015).

Authors herein report a case of a viable abdominal pregnancy discovered at term during emergency laparotomy for suspected uterine rupture.

The 24-year-old G2P0 patient was HIV-positive, under antiretrovirals, though AP exceptionally occurs in HIV patients.

She did only two antenatal consultations: her main complaint was abdominal pain but five echographies concluded to normal intrauterine pregnancy.

Findings at laparotomy were as follows: amnioperitoneum, a live female baby weighing 3.4 kilogrammes without deformities and a placenta deeply inserted on the uterine fundus.

Removal of the placenta triggered massive bleeding (2400 milliliters) with shock managed with a tourniquet on the lower uterine segment and fluid resuscitation.

Outcome was favourable for the mother and child.

Prevention of vertical transmission of HIV was successful with antiretroviral therapy.