Ectopic pregnancy
| Classification according to ICD-10 | |
|---|---|
| O00.0 | Abdominal pregnancy |
| ICD-10 online (WHO version 2019) | |
An ectopic pregnancy ( Peritonealgravidität or abdominal pregnancy ) is a rare form of an ectopic pregnancy . Only about 1% of all pregnancies that do not develop inside the uterus involve locations outside the fallopian tube . In addition to the abdominal cavity, the ovary itself should also be mentioned in these cases . The blastocyst - one of the first developmental stages of embryogenesis - can attach to both the parietal and the visceral peritoneum .
Since in an abdominal pregnancy, in contrast to an ectopic pregnancy, the delimitation of space does not play an essential role, warning symptoms are very different here and are therefore uncharacteristic. Here, too, the fruit dies in the vast majority of cases in different stages of development, but there are also case reports of ectopic pregnancies delivered to full term that were delivered by caesarean section .
Since the early symptoms generally correspond to those of early pregnancy, nowadays an ectopic pregnancy is recognized more quickly thanks to the improved diagnostic options. Since the risk of death for the pregnant woman is greater than the probability of survival of the fruit, an ectopic pregnancy, like the other forms of ectopic pregnancy, is often ended either surgically (laparoscopically, less often openly surgically) or medically ( methotrexate ).
If the patient insists on carrying the baby to term, as happens occasionally, an immediate inpatient admission until the birth is essential in order to treat sudden bleeding as quickly as possible. At the latest in the 32nd to 34th week of pregnancy, the pregnancy must then be terminated with a laparotomy . The actual operative challenge is the removal of the placenta , which is often overgrown with the retroperitoneum and has vessels as thick as a finger. If there is not a very high level of operative competence through oncological operations, leaving the afterbirth in the womb is an alternative that brings with it higher survival rates.
literature
- W. Pschyrembel , JW Dudenhausen: Practical obstetrics. 17th edition. Walter de Gruyter, Berlin 1991, ISBN 3-11-012881-0 , 565 ff.
- G. Masukume, E. Sengurayi, A. Muchara, E. Mucheni, W. Ndebele, S. Ngwenya: Full-term abdominal extrauterine pregnancy complicated by post-operative ascites with successful outcome: a case report. In: Journal of Medical Case Reports. 2013; 7 (1), p. 10. (PDF; 676 kB)
Web links
- Heike Le Ker: A puzzling patient: sensational pregnancy. In: Spiegel online. (on-line)
Individual evidence
- ↑ Birth after ectopic pregnancy
- ↑ L. Muehlparzer, W. doctor T. Ebner, G. Tews: Secondary abdominal pregnancy with live birth. In: Acta Obstetricia et Gynecologica Scandinavia. Vol. 90, 3, p. 288 (March 2011)
