Primary Abdominal Pregnancy Acting as a Bladder Tumor

Abstract

Tubal pregnancy accounts for 95% of the ectopic pregnancies, followed by ovarian (3.2%) and abdominal (1.3%) pregnancies.2 In abdominal pregnancies, the gestational sac is commonly implanted in the pelvis or in highly vascular areas, such as the liver and mesentery. Abdominal pregnancy is more common in developing countries. It can reach up to term, but fetal mortality is approximately 95%. The incidence of congenital anomaly is 20-40%, and abnormalities, such as intrauterine growth retardation, fetal pulmonary hypoplasia, compression deformities, and facial and extremity anomalies, can be seen. Therefore, perinatal mortality and morbidity are increased. Risk factors of abdominal pregnancy include pelvic inflammatory disease, multiparity, endometriosis, assisted reproductive techniques, and tubal injury. However, the primary reason for abdominal pregnancy in developing countries is the prevalence of increased pelvic inflammatory disease.3 The diagnostic criteria of primary abdominal pregnancies are as follows: normal tubae and ovaries; no uteroplacental fistula, early enough to rule out the possibility of secondary nidation; and presence of pregnancy on the peritoneal surface. Primary abdominal pregnancy refers to pregnancy where in the implantation of the fertilized ovum occurs directly in the abdominal cavity. In such cases, the fallopian tubes and ovaries are intact. Secondary abdominal pregnancy accounts for most cases of advanced extrauterine pregnancy. It occurs following a tubal pregnancy wherein the tube ruptures or aborts and the embryo is reimplanted within the abdomen.4 Most of the reported abdominal pregPrimary Abdominal Pregnancy Acting as a Bladder Tumor