Peritoneal Pregnancy : Definition, Causes, Symptoms, Complication and Treatment
Peritoneal Pregnancy Definition
Peritoneal pregnancy, also called abdominal pregnancy is a pregnancy that is characterized by the implantation of the fertilized egg into the abdominal cavity. This is a rare form of ectopic pregnancy (EP). Implantation, namely the implantation of the fertilized egg, is in the peritoneum. Further development of the egg into a fetus at this point is still rare.
Peritoneal Pregnancy Causes
To reach the uterus, where most fertilization takes place, the egg is normally done through the tubes. When the tubes are blocked or leaking, the egg can be diverted to the abdominal cavity. It can also result in tubal pregnancy.
Risk factors :
- History of abdominopelvic surgery
- History of salpingitis (caused by bacterial infections chlamydia)
- History of ectopic pregnancies
- Presence of an intrauterine
- Medically assisted procreation and fertility disorders
- Lesions in the fallopian tubes
Peritoneal Pregnancy Disorders (symptoms)
- Missed period (amenorrhoea)
- Pain in the abdomen or pelvis
- Positive pregnancy test with no embryo in the uterine cavity at ultrasound examination
- Vaginal bleeding, blood loss (bleeding) brownish or blackish
- Signs “sympathetic pregnancy” (nausea, breast tenderness)
In some women, pregnancy can be asymptomatic peritoneal.
Emergency : You must call the doctor / emergency physician in the following situations:
- Significant and unusual pelvic pain, especially if they are associated with a delayed period and a suspicion of pregnancy.
- Dizziness, fainting, loss of consciousness with suspected ectopic pregnancy that (cause: bleeding in the abdomen).
- Significant nausea and malaise.
Peritoneal pregnancy is a medical emergency because it can put the woman’s life in danger.
Peritoneal Pregnancy Examinations (diagnosis)
- History with consideration of current symptoms
- Pregnancy test
- Physical examination (the volume of the uterus is smaller than in normal pregnancy)
- Palpable painful swelling in the peritoneum
- Blood test with measurement of chorionic gonadotropin hormone, in normal pregnancy, the levels of this hormone doubles every two days during pregnancy peritoneal, increased levels of this hormone is very irregular.
- Laparoscopy (laparoscopic surgery)
Peritoneal Pregnancy Treatment Options
Nearly half of pregnancies are spontaneously peritoneal.
When the pregnancy develops in the peritoneum, it should proceed with surgery. In most cases, this procedure is a laparoscopy, in rarer cases, the surgeon must perform a laparotomy with opening the abdomen. Problems can arise when the placenta is stuck against other organs like the intestine. The removal of part of the intestine may then be necessary.
- In very recent pregnancy (egg less than 3 cm), local injection of methotrexate guided by ultrasound blocks the division of the egg. This method is used primarily in cases of tubal pregnancy.
- Methotrexate can also be administered intravenously or intramuscularly, but only in the absence of intraperitoneal bleeding or when the egg is still very small.
Peritoneal Pregnancy Possible Complications
Advanced peritoneal pregnancy is a medical emergency requiring immediate treatment. The risk of having another pregnancy peritoneal is about 20%.
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