title: Fetal MRI in the pre-operative diagnosis and assessment of secondary abdominal pregnancy: a rare sequela of a previous caesarean section.
abstract: Secondary abdominal pregnancy is a rare type of ectopic pregnancy. Following     fertilization, the blastocyst escapes from the uterine cavity and implants in     the peritoneal cavity. The early antenatal diagnosis and identification of the     site and extent of placental implantation in an abdominal pregnancy are     important to prepare for the eventual surgery. We present the case of a     24-year-old patient presenting with loss of fetal movement at 26 weeks of     gestation for whom an abdominal pregnancy was suspected on ultrasonography and     later confirmed on magnetic resonance imaging (MRI). She had one caesarean     section in the past. The MRI findings suggested a scar dehiscence. She was     eventually managed surgically, and the unviable fetus was removed. Abdominal     pregnancies must be treated as emergencies. They usually present with     complications such as fetal death and intra-abdominal hemorrhaging and can be     easily missed on routine antenatal ultrasonography. The exact anatomical     relationships of the fetus, the placenta, and vital maternal intra-abdominal     structures can be accurately delineated with MRI, which greatly aids the     management of patients with abdominal pregnancy. A proposed imaging protocol and     technical suggestions for improving the diagnostic capability of ultrasonography     and MRI in abdominal pregnancies have been provided to aid in the appropriate     evaluation of suspect cases.
authors.affiliation: Department of Radiodiagnosis, Ganesh Shankar Vidhyarthi Memorial Medical College, Kanpur, India. mittalshireesh@gmail.com
authors.forename: Shireesh Kumar
authors.initials: SK
authors.lastname: Mittal
authors.forename: Neetu
authors.initials: N
authors.lastname: Singh
authors.forename: Ashok Kumar
authors.initials: AK
authors.lastname: Verma
authors.forename: Himanshu
authors.initials: H
authors.lastname: Agarwal
authors.forename: Chaitanya D
authors.initials: CD
authors.lastname: Kulkarni
authors.forename: Reeta
authors.initials: R
authors.lastname: Kanaujia
mesh_terms: D000032:Abortion, Therapeutic / Q000379:methods; D002585:Cesarean Section / Q000009:adverse effects*; D017352:Echo-Planar Imaging / Q000379:methods*; D004630:Emergencies; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D007813:Laparotomy / Q000379:methods; D011247:Pregnancy; D011269:Pregnancy, Abdominal / Q000175:diagnosis* / Q000601:surgery*; D011271:Pregnancy, Ectopic / Q000000981:diagnostic imaging / Q000601:surgery; D011296:Prenatal Diagnosis / Q000379:methods*; D011300:Preoperative Care / Q000379:methods; D035583:Rare Diseases; D016896:Treatment Outcome; D016216:Ultrasonography, Prenatal / Q000379:methods; D055815:Young Adult