**6. Acknowledgment**

Address all correspondence and requests for reprints to: Assoc. Professor Blazej Meczekalski, Chairman of the Department of Gynecological Endocrinology, Poznan University of Medical Sciences, Poznan, ul. Polna 33, 60-535 Poznan, Poland.

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Disclosure Statement: The authors have nothing to declare.

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**10** 

*1Saudi Arabia 2Canada* 

**Term Extra-Uterine Pregnancy** 

*1King Faisal Specialist Hospital & Research Center* 

Ismail A. Al-Badawi1, Osama Al Omar1 and Togas Tulandi2

*2Department of Obstetrics and Gynecology, McGill university, Montreal, Quebec,* 

Extrauterine pregnancies rarely reach third trimester of gestation. However, abdominal pregnancy can result in term delivery. Term cervical pregnancy has also been reported. The

Our objective is to review cases of term extra-uterine pregnancy and to evaluate its consequences on the mother and the fetus. Due to its ill impact, the best management is early diagnosis and treatment. Prolongation of an ectopic pregnancy should be avoided.

AP represents a variant of ectopic gestation in which the conceptus is sited in the abdominal cavity, external to the uterus, fallopian tubes and broad ligament (1, 2). Devoid of endometrial support, the placenta may attach to the peritoneum, bowel, uterine serosa and omentum. AP is the rarest form of ectopic pregnancy, with an incidence of 1% of all ectopic

AP is defined as advanced once fetal viability is reached. At this stage AP carries significantly high mortality rates for both mother (0-20%) and fetus/newborn (40-95%) (2,

A high index of suspicion for this rare and serious condition, complemented by often nonspecific findings in the clinical history and physical examination may lead to a timely correct diagnosis. Recurrent abdominal pain and tenderness, a relatively mobile abdominal mass in an amenorrheic woman of reproductive age, painful fetal movements in the upper abdomen associated with a persistently abnormal lie, fetal heart sounds localized in the upper epigastrium, should raise the possibility of an AP and be followed by an ultrasound examination (5). In early pregnancy the diagnosis of AP might be missed by failure to obtain an image demonstrating continuity of the vagina, cervix and uterus with its pregnancy contents (1). Four ultrasound criteria have been suggested to support the diagnosis of AP: (1) absence of an intrauterine gestational sac, (2) absence of both an evident dilated tube and a complex adnexal mass, (3) a gestational sac surrounded by loops of bowel and separated

4). The latter is partly due to a 20-40% rate of congenital fetal malformations (4).

**2. Abdominal pregnancy (AP) reaching fetal viability or term** 

**1. Introduction** 

gestations (3).

**2.2 Diagnosis** 

most unusual is term tubal ectopic pregnancy.

**2.1 Introduction/definition/incidence** 

