Radiological Diagnosis of Extrauterine Gestation Using Computed Tomography and Ultrasonography: A Case Report in a Specialist Hospital in Port Harcourt, Nigeria

Abstract

Abdominal gestation is an infrequent form of ectopic gestation, noticed in 1:10,000 to 1:30,000 pregnancies and accounting for up to 1.4% of all ectopic gestations. It is classified as primary or secondary based on site of fertilization. Still, when it does occur, it goes on unnoticed until term because the pregnancy can appear normal during clinical checkup. Progressive abdominal gestation is connected with high death rate for both mother and the baby at 1-20% and 40-95% respectively. Our case study is a 36-years-old woman Gravida 3 Para 2+0(1 Alive) at 16 weeks 6 days Gestation age(GA) who presented to the Radiology department for an abdominopelvic ultrasound scan investigation on account of mild-moderate abdominal pain and amenorrhea. The abdominal ultrasound shows an inactive fetus with positive spalding sign in the abdomen. The placenta is attached to the omentum, the uterus is empty. Other abdominal organs are within normal.  Biparietal diameter (BPD) measures 35.60mm with a GA of 16 weeks 6 days, a correlating NCECT scan was done. The importance of this case report is to highlight the role of imaging in the diagnosis of abdominal pregnancy in developing countries. Ultrasound alone cannot be relied on to make the diagnosis, so other imaging modality should be employed based on the presence of fetal cardiac activity. In this case non-contrast enhanced computed tomography(NCECT) was done which cleared all the doubt. In addition to highlighting the role of imaging in diagnosis, the aim is also to report this study as it has not been reported in our environment.