Advanced abdominal pregnancy is associated with catastrophic outcomes for both mother and fetus. Because it is rare, it is often misdiagnosed and the surgery, often unplanned, may end up with uncontrollable hemorrhage and injury to abdominal structures during placental removal. A case of a 21-year-old G1P0, 34 weeks gestation, who presented as a bleeding placenta previa but diagnosed intraoperatively as abdominal pregnancy with a live baby with congenital anomalies, with complete removal of the placenta and with good maternal outcome is presented. This report highlights the pitfalls in diagnosis and stresses the importance of team management, adherence to good surgical principles, and timely operative decisions to ensure a successful outcome when preoperative evaluation is not possible.
Pregnancy, Ectopic

Arteriovenous malformations (AVM) are vascular disorders with a mixture of arterial, venous and small capillary-like channels with fistulous connections. Uterine arteriovenous malformations are rare cause of abnormal uterine bleeding with only a few reported cases. They may arise from pregnancy, miscarriage, previous cesarean section or other uterine surgery and gestational trophoblastic disease. Diagnosis can be made through angiography or doppler ultrasonography. Traditionally, uterine AVMs are treated with hysterectomy but with the advances in technology, minimally invasive conservative approaches such as radiologic arterial embolization or laparoscopic uterine artery ligation have become available. We present a case of a 29-year-old, G2P1 (1011) who had a three- month history of heavy, intermittent vaginal bleeding from uterine arteriovenous malformation after a miscarriage. Laparoscopic bilateral uterine artery occlusion, offered a minimally invasive treatment with high symptomatic effectiveness.
Uterine Artery ; Arteriovenous Malformations ; Uterine Diseases ; Ligation ; Uterine Hemorrhage