Abdominal pregnancy in Libreville from 1999 to 2009

Introduction. - Abdominal pregnancy (AP) is defined as the implantation and development of the fertilised egg in the cavity of peritoneum. It causes severe perinatal morbity and mortality. Objective. - Underline the epidemiologic, diagnostic, therapeutic and prognostic aspects of the AP. Methodology. - Retrospective study conducted at Maternite Josephine Bongo (maternity hospital) and at the Centre Hospitalier de Libreville (hospital centre) from January 1999 to December 2009 on 19 cases of abdominal pregnancies. Results. - The frequency of AP in Libreville is one per 4447 deliveries (0.2 parts per thousand) and one per 141 tubal ectopic pregnancies (0.7%). The mean age was 30.5 +/- 7.2 years old and the mean parity 2.7 +/- 1.7. The mean term of occurrence was 24.3 weeks of amenorrhoea (WA) with extremes at 14 and 39 WA. The diagnosis was made in the face of abdominal and pelvic pains in all the patients and an amenorrhoea in 11 cases (57%). It was confirmed by ultrasound scan in 14 cases (73.7%) and further to a laparotomy in five (26.3%) patients. We had two live births at 39 and 38 WA with respective birth weights of 2,380 and 2,550g. Expulsion of the placenta was complete in seven (36.8%) cases. Five (26.3%) patients experienced hemorrhagic complications. Conclusion. - AP is a rare pathology. Its diagnosis beyond of the second quarter is difficult with an often-pejorative foetal forecast. (C) 2011 Elsevier Masson SAS. All rights reserved.