Results
We reviewed 314 cases of abdominal pregnancies, both early and advanced,
from 1930-2021. Table 1 outlines the details reported by various authors
and table 2 summarises the management and maternal and fetal outcomes.
In our current series, 295 cases (93.9%) were surgically managed and 19
cases (6%) required hysterectomy. Post-surgery adjuvant methotrexate
was given in 9 cases (2.9%) and ultrasound guided percutaneous
microwave ablation was performed in one patient with diaphragmatic
ectopic. Ten out of 18 patients (55.5%) required surgical intervention
following primary methotrexate. Complete removal of the placenta can be
a daunting task in certain cases. We found that complete removal was
achieved in 264 cases (84%), partial in 27 cases (8.6%) and left in
situ in 16 cases (5.1%). Due to lack of longterm follow-up and paucity
of data, the postoperative complications like intraabdominal sepsis and
bleeding where the placenta was left insitu could not be analysed.
Maternal mortality and morbidity is a matter of serious concern in
abdominal pregnancies and a high index of suspicion and management
expertise is required. In this series, 74 cases (23.6%) required
transfusion of blood and blood products. There were 15 maternal deaths
(4.8%).
Regarding the neonatal outcome, 241 cases (76.8%) were abdominal
pregnancies <20 weeks of gestation. In the advanced abdominal
pregnancies after 20 weeks of gestation, 27 fetuses (8.6%) were live
born, 6 (1.9%) were neonatal deaths and 46 (14.6%) were fetal demise
in utero or stillborn.