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.
Department of Obstetrics and Gynecology, Kilimanjaro Christian Medical Centre, Tumaini University, Tanzania, East Africa.
Olola
O
Oneko
Edgar
E
Petru
Gileard
G
Masenga
Daniela
D
Ulrich
Joseph
J
Obure
Willibald
W
Zeck
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