The Used of Magnetic Resonance Imaging in Managing Intra-Abdominal Pregnancy: A Case Report

Zainul Ikhwan Ahmad Khusairi; Nor Aroma Abu Bakar; Tang Ling Sze; Mohammad Nasir Abdul Kudus; Norhayati Hamzah; Nor Zorrenee Zorkarphy

doi:10.55265/halalreviews.v4i1.15

Authors

Zainul Ikhwan Ahmad Khusairi Emergency and Trauma Department, Taiping Hospital, Perak, Malaysia
Nor Aroma Abu Bakar Imam Abdulrahman Bin Faisal Hospital, Dammam, Saudi Arabia
Tang Ling Sze Emergency and Trauma Department, Taiping Hospital, Perak, Malaysia
Mohammad Nasir Abdul Kudus Open University Malaysia
Norhayati Hamzah KMC Medical Centre, Ipoh, Perak, Malaysia
Nor Zorrenee Zorkarphy Open University Malaysia

DOI:

https://doi.org/10.55265/halalreviews.v4i1.15

Keywords:

magnetic resonance imaging (MRI), intra-abdominal pregnancy

Abstract

Most women will experience a normal pregnancy process. However, there are some complications that may occur during the pregnancy. Pregnancy outside of the uterus is also known as intra-abdominal pregnancy. Intra-abdominal pregnancy is among the complications during pregnancy that are commonly reported besides abortion, Pregnancy Induced Hypertension (PIH) and Gestational Diabetes Mellitus (GDM). These complications are believed to be the main cause of the increase in maternal and perinatal death rate. Therefore, the used of appropriate diagnostic imaging in management of obstetric cases should be focused. Thus this case study is intended to evaluate the used of Magnetic Resonance Imaging (MRI) in managing intra-abdominal pregnancy. The study focused on one case of abdominal pregnancy which continued into the second trimester. A 30-year-old woman, G2 P0+1 at 12-13 weeks’ gestation presented to public hospital complaining of recurrence epigastric pain with no history of vaginal bleeding. An MRI was performed and the mother was identified as having an intra-abdominal pregnancy. Urgent laparotomy done. Intraoperative noted heamoperitoneum with active bleed seen from the placenta that adhere to the omentum. Partial omentectomy was done. The fetus about 14 week’s gestation are seen and removed. Case studies have proven that the option to perform an MRI on a suspected intra-abdominal pregnancy can help provide information to establish an accurate diagnosis and appropriate patient care management. Therefore, the use of MRI is highly recommended for all cases that are expected to experience intra-abdominal pregnancy as to save the patient and as well as to avoid obstetric complications.

References

Althabe, F., Moore, J. L., Gibbons, L., Berrueta, M., Goudar, S. S., Chomba, E., Derman, R. J., Patel, A., Saleem, S., Pasha, O., Esamai, F., Garces, A., Liechty, E. A., Hambidge, K., Krebs, N. F., Hibberd, P. L., Goldenberg, R. L., Koso-Thomas, M., Carlo, W. A., Cafferata, M. L., … McClure, E. M. (2015). Adverse maternal and perinatal outcomes in adolescent pregnancies: The Global Network's Maternal Newborn Health Registry study. Reproductive health, 12 Suppl 2(Suppl 2), S8. https://doi.org/10.1186/1742-4755-12-S2-S8 DOI: https://doi.org/10.1186/1742-4755-12-S2-S8

Audu, B.M., Takai, V.I., & Bukar, M. (2010). Trends in maternal mortality at University of Mariduguri Hospital, Negeria. Negeria Medical Journal, 51(4), 147–151.

Bertand, G., Le, R., Simard-Emond, L., & et al. (2009). Imaging in the management of abdominal pregnancy: A case report and review of the literature. JOGC, 57-62. DOI: https://doi.org/10.1016/S1701-2163(16)34055-5

Chilton, S., Bain, H., Clarridge, A., & Melling, K. (2016). Community Nursing. Philadelphia: Hodder Arnold.

Cissé, C.A.T., De Bernis, L., Faye, E.O., & Diadhiou, F. (2002). Ectopic pregnancy in Senegal. Health Records, 12(2), 271-274.

DOSM. (2011). “Statistic of Mortality and Morbidity in 2008 to 2009”. Department of Statistics Malaysia. https://www.dosm.gov.my/portal-main/landingv2

Ganchimeg, T., Ota, E., Morisaki, N., Laopaiboon, M., Lumbiganon, P., Zhang, J., Yamdamsuren, B., Temmerman, M., Say, L., Tunçalp, Ö., Vogel, J. P., Souza, J. P., Mori, R., & WHO Multicountry Survey on Maternal Newborn Health Research Network (2014). Pregnancy and childbirth outcomes among adolescent mothers: a World Health Organization multicountry study. BJOG : an international journal of obstetrics and gynaecology, 121(1), 40–48. https://doi.org/10.1111/1471-0528.12630 DOI: https://doi.org/10.1111/1471-0528.12630

Karat, L.S. (2007). Viable Abdominal Pregnancy. Journal Obstetric Gynecol India, 57(2), 169-170.

KKM. (2016). “Perkhidmatan Kesihatan Komuniti di Malaysia”. Kementerian Kesihatan Malaysia. https://www.moh.gov.my/index.php/database_stores/store_view/33

Kun K.Y., Wong, P.Y., Ho, M.W., & et al. (2000). Abdominal pregnancy presenting as missed abortion at 16 weeks’ gestation. HKMJ, 6, 425-427.

Malian, V., & Lee, J.H. (2001). MR imaging and MR angiography of an abdominal pregnancy with placental infarction. AJR. Am. JRoentgenol., 177, 1305-1306. DOI: https://doi.org/10.2214/ajr.177.6.1771305

Murthy, B. K., Murthy, M. B., & Prabhu, P. M. (2013). Maternal Mortality in a Tertiary Care Hospital: A 10-year Review. International journal of preventive medicine, 4(1), 105–109.

Nkwabong, E., & Tincho, E.F. (2012). A case of a 26-week ampullary pregnancy mimicking intrauterine fetal death. Anatol. Journal Obstetric Gynecology, 1(2), 1-3.

Nwobodo, E.I. (2004). Abdominal pregnancy. A case report. Annual African Medicine, 3(4), 195-196.

Sachan, R., Gupta, P., & Patel, M.L. (2012). Second trimester unruptured ampullary ectopic pregnancy with variable presentation: Two unusual cases. IJCRI, 3(8), 1-4. DOI: https://doi.org/10.1136/bcr-2012-006665

Say, L., Chou, D., Gemmill, A., Tunçalp, Ö., Moller, A.B., Daniels, J.D., & et al. (2014). Global Causes of Maternal Death: A WHO Systematic Analysis. Lancet Global Health, 2(6), 323-333. DOI: https://doi.org/10.1016/S2214-109X(14)70227-X

Spalluto, L.B., Woodfield, C.A., DeBenedictis, C.M., & et al., (2012). MR imaging evaluation of abdominal pain during pregnancy: Appendicitis and other non-obstetric causes. Radiographics, 32(2), 317-334. DOI: https://doi.org/10.1148/rg.322115057

Teng, H. C., Kumar, G., & Ramli, N. M. (2007). A viable secondary intra-abdominal pregnancy resulting from rupture of uterine scar: role of MRI. British Journal of Radiology, 80(955), 134-136. DOI: https://doi.org/10.1259/bjr/67136731

Yoshigi, J., Yashiro, N., Kinoshito, T., O’uchi, T., & Kitagaki, H. (2006). Diagnosis of ectopic pregnancy with MRI: efficacy of T2-weighted imaging. Magnetic Resonance Medical Science, 5, 25-32. DOI: https://doi.org/10.2463/mrms.5.25