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

J Womens Health (Larchmt)

Department of Obstetrics and Gynecology, Kilimanjaro Christian Medical Centre, Tumaini University, Tanzania, East Africa.

Published: July 2010

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.

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http://dx.doi.org/10.1089/jwh.2009.1704DOI Listing

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