A case illustrating the continued dilemmas in treating abdominal pregnancy and a potential explanation for the high rate of postsurgical febrile morbidity.
BACKGROUND
Abdominal pregnancy is potentially highly morbid and often complicated by postoperative fever.


METHODS
A 29-year-old gravida 2 para 0 presented with a 17-week size-demised abdominal pregnancy. We describe the continued difficulty in determining the timing and type of intervention. In addition, we found that the gestational sac was colonized by group B streptococcus at the time of surgery.


CONCLUSIONS
This case illustrates that preoperative colonization of the intra-abdominal gestational sac may contribute to postoperative febrile morbidity. We suggest treating patients with prophylactic antibiotics and avoiding spill of gestational sac contents into the peritoneal cavity. Placement of a sterile Foley bulb into the uterine cavity can confirm the extrauterine position of the pregnancy prior to undertaking surgery.
Bergstrom
R
R
Department of Obstetrics and Gynecology, University of Iowa School of Medicine, Iowa City, Iowa, USA.
Mueller
G
G
Yankowitz
J
J
D000328:Adult; D000667:Ampicillin / Q000627:therapeutic use; D015313:Cefotetan / Q000627:therapeutic use; D002513:Cephamycins / Q000627:therapeutic use; D005260:Female; D005313:Fetal Death; D005334:Fever / Q000209:etiology*; D006801:Humans; D010406:Penicillins / Q000627:therapeutic use; D010532:Peritoneal Diseases / Q000382:microbiology; D011247:Pregnancy; D011269:Pregnancy, Abdominal / Q000150:complications* / Q000175:diagnosis / Q000601:surgery*; D013290:Streptococcal Infections / Q000188:drug therapy / Q000209:etiology; D013292:Streptococcus agalactiae
D002513:Cephamycins; D010406:Penicillins; D015313:Cefotetan; D000667:Ampicillin