Advanced Abdominal Pregnancy with Retained Placenta and Methotrexate-Induced Severe Bone Marrow Suppression: A Case Report
Journal Title: Biomedical Journal of Scientific & Technical Research (BJSTR) - Year 2018, Vol 19, Issue 4
Abstract
placenta remains in situ after laparotomy this may result in fetal complications. We report a case of advanced abdominal pregnancy with live fetus salvaged by laparotomy with the whole placenta retained. The patient was a 24 years old woman with amenorrhoea of 33 weeks’ duration and abdominal pain. Her laboratory test results were unremarkable except for mild anaemia and low serum albumin. Laparotomy was carried out with the whole placenta retained. Severe bone marrow suppression with repeated hyperthermia occurred after treatment with methotrexate (MTX, 20 mg/day for four days). Antibiotic treatment lasted for 25 days and the patient was discharged on post-operative day 30. This case indicates that prenatal education and check-up are of great importance for early detection. Methotrexate is an alternative treatment choice for patients with placental retention in situ but may result in severe bone marrow suppression, even at small doses. Precautions should be taken in anticipation of adverse side effects. Abdominal pregnancy is a rare type of ectopic pregnancy, defined as implantation located in the peritoneal cavity outside of the uterus, fallopian tube, ovary and ligamentum. Abdominal pregnancy accounts for approximately 1% of ectopic pregnancies, and ectopic pregnancies account for 1–2% of all pregnancies.1 Several reports have cited high perinatal mortality rates ranging from 80 to 95%.2,3 Clinical features of abdominal pregnancy range from asymptomatic to severe complaints. The most common symptom was abdominal pain after amenorrhoea, followed by vaginal bleeding. The non-specific manifestations of abdominal pregnancy make it difficult to identify from other ectopic pregnancies without further examination for a differential diagnosis. In this report, we describe a rare case of advanced abdominal pregnancy with live fetus salvaged by laparotomy with the whole placenta retained.
Authors and Affiliations
Lingyan Xu, Zhenzhen Xiang, Tianxia Wu, Suwen Feng
Keywords
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- EP ID EP622442
- DOI 10.26717/BJSTR.2019.19.003341
- Views 159
- Downloads 0
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