Management of the placenta in advanced abdominal pregnancies at an East african tertiary referral center

J Womens Health (Larchmt). 2010 Jul;19(7):1369-75. doi: 10.1089/jwh.2009.1704.

Abstract

Objective: To review the diagnosis and treatment of 9 advanced abdominal pregnancies in a low-resource setting of a developing country, focusing on the management of the placenta.

Methods: Abdominal pregnancies occurring between 1999 and 2007 were identified from hospital records in Tanzania. All patients were followed up for a median of 6 months after surgery (range 5-9 months).

Results: At the time of diagnosis, pregnancies were between 20 and 42 weeks of gestation (median 27 weeks). All 9 mothers survived the abdominal pregnancy, and 7 fetuses died before delivery. The placenta was left completely in situ in 5 of the nine cases.

Conclusions: Abdominal pregnancy is often detected rather late in low-resource settings compared with higher-resource settings. We suggest that in the described low-resource setting where red blood cell transfusions are not always readily available, the placenta may be left in situ after removal of the fetus.

MeSH terms

  • Adolescent
  • Adult
  • Developed Countries
  • Female
  • Fetal Death / etiology
  • Follow-Up Studies
  • Humans
  • Infant, Newborn
  • Placenta*
  • Pregnancy
  • Pregnancy Outcome
  • Pregnancy, Abdominal / surgery*
  • Tanzania
  • Young Adult