title: Advanced abdominal pregnancy: case report and review of 163 cases reported since 1946.
abstract: BACKGROUND
  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.
  
  
  OBJECTIVE
  
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Kolofata District Hospital, Extrême-Nord, Cameroon. danielnkusu@yahoo.fr
authors.forename: Daniel
authors.initials: D
authors.lastname: Nkusu Nunyalulendho
authors.forename: Ellen M
authors.initials: EM
authors.lastname: Einterz
mesh_terms: D000328:Adult; D002163:Cameroon; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008427:Maternal Health Services; D008429:Maternal Welfare; D011247:Pregnancy; D011256:Pregnancy Outcome; D011269:Pregnancy, Abdominal / Q000175:diagnosis* / Q000601:surgery*; D012424:Rural Population