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Re: Can this be real?From: Dr.Guichard (sguich@transnethaiti.com)Sat Oct 9 15:44:42 2004
Dear Terry, Its really an amazing image,very suggestive of an abdominal pregnancy.I had surgery for a patient 3 month ago with an abdominal pregnancy at term with a living baby. The diagnosis can be very difficult when the patient is seen at term . Couples of clinical signs: -prolonged pregancy -perception of fetal parts at abdominal palpation(now you could add:visualisation of fetal parts) -diffuse abdominal pain -unusual fetal presentation and placental location. They key diagnosis is the identification of an empty uterus at vaginal US (the use of an hysterometer or hysterosono will help). -Extraction of the fetus is easy but the placenta is the big problem,be ready for hemorrhage and prepare for massive blood transfusion. -sometimes it' s wise to leave the placenta in the abdomen and close.It will necroses. Serge Guichard ObGyn, Haiti
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