Sonographic Triad In Abdominal Pregnancy: Illustration With Four Cases
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Abstract
Background: Abdominal pregnancy (AP) is a rare form of ectopic gestation with a high morbidity and mortality. The diagnosis is difficult because of its relatively non-specific asymptomatic nature and non-specificity of symptoms. Ultrasonography may be the first pointer to the diagnosis.
METHODS: Four cases of AP diagnosed between 16-38weeks gestation and had laparotomy confirmations are presented. Focused obstetrics ultrasound scans, which sought to identify the upper vagina, cervix and uterus assisted our diagnosis.
RESULTS: Our first case of AP was missed at ultrasonography. Thereafter, three consecutive cases were correctly diagnosed. Only one out of our four patients had the pregnancy delivered of live baby. The unique sonographic features common to all are triad of masses: the empty uterus, the placenta and the closely packed bowel loops with omentum.
CONCLUSIONS: In obstetrics scan, the finding of unusual lower intra-abdominal masses during panoramic scans should arouse Sonologists or Sonographers to suspect AP until rigorous and lucid pelvic ultrasound scans that must have identified the upper vagina, cervix and the uterus prove otherwise.
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