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Advanced abdominal pregnancy: case report and review of 163 cases reported since 1946 Nkusu Nunyalulendho D; Einterz EMRural Remote Health 2008[Oct]; 8 (4): 1087CONTEXT: Though relatively rare, advanced abdominal pregnancy (AAP) can have dramatic and catastrophic consequences for the foetus and the mother. Difficult to diagnose pre-operatively, AAP presents special challenges to the physician working in remote areas with limited resources for diagnosis and management. CASE REPORT: A case of AAP received in our hospital in Kolofata, Cameroon, is presented and followed by a review of 163 other cases reported from 13 countries since 1946. LESSONS LEARNED: A physician working in a remote district with an active maternity service should expect to encounter several cases of AAP during his or her working lifetime. Pre-operative diagnosis of AAP allows time for thoughtful preparation of the patient, family and medical team; however, to be diagnosed, AAP must first be considered. Diagnosis requires a high index of suspicion, and this should be triggered by any of a number of symptoms and signs reported in many cases of AAP. An unusual echographic appearance of the placenta was present in our case and prompted a more thorough investigation that confirmed the diagnosis. This finding has been reported by others and should be added to the list of signs and symptoms that might lead to a diagnosis of AAP in time to save the surgeon from an unpleasant and dangerous surprise.|*Maternal Welfare[MESH]|*Rural Population[MESH]|Adult[MESH]|Cameroon[MESH]|Female[MESH]|Humans[MESH]|Infant, Newborn[MESH]|Maternal Health Services[MESH]|Pregnancy[MESH]|Pregnancy Outcome[MESH]|Pregnancy, Abdominal/*diagnosis/*surgery[MESH] |
