PMC4743745_01
Ultrasound 2D showing empty uterus with placenta attached to fundus with blood supply from uterus and fetal head in abdomen (A), whole fetus seen intraabdominal not surrounded by uterine wall and anhydraminos (B), and maternal liver seen beside fetal liver characteristic of extra uterine location of fetus (C).
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A repeat abdominal ultrasound examination was done in our hospital that showed an empty uterus with a single live fetus seen outside uterine cavity with no amniotic fluid in the amniotic sac surrounding it (Fig. 1).
Steps of the operation. Midline laparotomy (A), entering abdominal cavity with fetal leg seen with gangrenous toe in the peritoneal cavity outside the uterus (B), extraction of the fetus by breech extraction (C), complete delivery of fetus with omental bands around fetal legs and body (D), omental bands around fetal toes with resulting gangrene with amniotic membrane covering the fetus with no liquor in peritoneal cavity (E), and vigorous female baby with amniotic membrane around the fetus with omental bands attached (F).
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The patient underwent exploratory laparotomy under general anesthesia through lower midline incision (Fig. 2-6).
Continuation of the steps. Normal fetus (A), clamping and cutting of cord (B), disentanglement and removal of omental bands from toes of the baby (C), delivering the uterus outside the abdomen (D), placenta attached to the fundus of the uterus (E), and dissection of the colon from the uterus (F).
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The patient underwent exploratory laparotomy under general anesthesia through lower midline incision (Fig. 2-6).
Steps of hysterectomy. Dissection of the colon (A), placenta separation occurred spontaneously with severe bleeding and morbid attachment (B), delayed ligation technique (C), suturing the stump and the pedicles (D), omental adhesions to the uterine specimen (E), clamping and excision of the omental adhesions (F), ligating the omentum after excision (G).
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The patient underwent exploratory laparotomy under general anesthesia through lower midline incision (Fig. 2-6).
Hysterectomy specimen with artery forceps in the cervix showing thinning out of myometrium near fundus with the suspicion of early ruptured cornual pregnancy with attachment of the placenta to the fundus with omental adhesions.
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The patient underwent exploratory laparotomy under general anesthesia through lower midline incision (Fig. 2-6).
Cut section in the hysterectomy specimen with empty cavity and placenta attached to the fundus with no plane of separation.
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The patient underwent exploratory laparotomy under general anesthesia through lower midline incision (Fig. 2-6).