FETAL SURVIVAL IN ABDOMINAL PREGNANCY - A REVIEW OF 11 CASES

Purpose: Little has been written regarding the ultrasound imaging feat ures that might allow prediction of fetal viability in abdominal pregn ancies. Toward this goal, we present our experience with a series of 1 1 abdominal pregnancies.Materials and Methods: From 1981 to 1993, 11 p atients presented to Universidad Catolica, Santiago, and Universidad d e Austral, Valdivia, Chile, with third trimester abdominal pregnancies . Five had complete ultrasound examinations, and these five patients w ere managed expectantly. The other six women presented as acute abdomi nal emergencies and underwent emergent surgery. Results: Four of five fetuses that survived had a complete placental attachment to the uteru s, and one surviving neonate had a partial attachment of the placenta to the uterus. Three fetuses died prior to delivery, and all three had a complete mesenteric placental attachment. Two died in the early neo natal period. One had a complete uterine placental attachment, and the other had a partial attachment. Conclusions: The survival rate of abd ominal pregnancies may be better than is generally believed. Placental attachment to the uterus appears to be a factor related to fetal surv ival and maternal morbidity. More cases are necessary to determine the feasibility of managing women with abdominal pregnancies expectantly. (C) 1996 John Wiley & Sons, Inc.