Improving the Management of an Advanced Extrauterine Pregnancy Using Pelvic Arteriography in a Hybrid Operating Suite

Abstract

Advanced extrauterine pregnancy is an extremely rare, life-threatening pregnancy complication. Management of these pregnancies presents significant challenges, especially when they have progressed to an advanced stage of fetal viability. With high rates of maternal and fetal mortality associated with this complication, delivery or pregnancy interruption should be expedited following diagnosis. Localization of the placenta and its blood supply is critical to preoperative planning. Hybrid operating suites that can accommodate a multidisciplinary team of subspecialists may improve the chance of a successful outcome with this rare complication.

Keywords

advanced extrauterine pregnancy - abdominal pregnancy - pelvic arteriography

• References

• 1 Atrash HK, Friede A, Hogue CJ. Abdominal pregnancy in the United States: frequency and maternal mortality. Obstet Gynecol 1987; 69 (3 Pt 1) 333-337
• 2 Hall JM, Manning N, Moore NR, Tingey WR, Chamberlain P. Antenatal diagnosis of a late abdominal pregnancy using ultrasound and magnetic resonance imaging: a case report of successful outcome. Ultrasound Obstet Gynecol 1996; 7: 289-292
• 3 Nkusu Nunyalulendho D, Einterz EM. Advanced abdominal pregnancy: case report and review of 163 cases reported since 1946. Rural Remote Health 2008; 8: 1087
• 4 Oneko O, Petru E, Masenga G, Ulrich D, Obure J, Zeck W. Management of the placenta in advanced abdominal pregnancies at an East African tertiary referral center. J Womens Health (Larchmt) 2010; 19: 1369-1375
• 5 Oki T, Baba Y, Yoshinaga M, Douchi T. Super-selective arterial embolization for uncontrolled bleeding in abdominal pregnancy. Obstet Gynecol 2008; 112 (2 Pt 2) 427-429
• 6 Worley KC, Hnat MD, Cunningham FG. Advanced extrauterine pregnancy: diagnostic and therapeutic challenges. Am J Obstet Gynecol 2008; 198: 297 , e1–e7