Management of the placenta in advanced abdominal pregnancies at an East african tertiary referral center.
OBJECTIVE
To review the diagnosis and treatment of 9 advanced abdominal pregnancies in a low-resource setting of a developing country, focusing on the management of the placenta.


METHODS
Abdominal pregnancies occurring between 1999 and 2007 were identified from hospital records in Tanzania. All patients were followed up for a median of 6 months after surgery (range 5-9 months).


RESULTS
At the time of diagnosis, pregnancies were between 20 and 42 weeks of gestation (median 27 weeks). All 9 mothers survived the abdominal pregnancy, and 7 fetuses died before delivery. The placenta was left completely in situ in 5 of the nine cases.


CONCLUSIONS
Abdominal pregnancy is often detected rather late in low-resource settings compared with higher-resource settings. We suggest that in the described low-resource setting where red blood cell transfusions are not always readily available, the placenta may be left in situ after removal of the fetus.
Oneko
Olola
O
Department of Obstetrics and Gynecology, Kilimanjaro Christian Medical Centre, Tumaini University, Tanzania, East Africa.
Petru
Edgar
E
Masenga
Gileard
G
Ulrich
Daniela
D
Obure
Joseph
J
Zeck
Willibald
W
D000293:Adolescent; D000328:Adult; D019049:Developed Countries; D005260:Female; D005313:Fetal Death / Q000209:etiology; D005500:Follow-Up Studies; D006801:Humans; D007231:Infant, Newborn; D010920:Placenta; D011247:Pregnancy; D011256:Pregnancy Outcome; D011269:Pregnancy, Abdominal / Q000601:surgery*; D013636:Tanzania; D055815:Young Adult