{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T21:10:48Z","timestamp":1792185048722,"version":"4.4.0"},"reference-count":24,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2015,5,1]],"date-time":"2015-05-01T00:00:00Z","timestamp":1430438400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Womens Health (Lond Engl)"],"published-print":{"date-parts":[[2015,5]]},"abstract":"<jats:p> We report three cases illustrating difficulties in diagnosis and challenges with management of the placenta in a low-resource country where ultrasound scanning, methotrexate, interventional radiology or blood products are often not accessible for the majority of patients. Even in situations where an ultrasound scan is available prenatally as in our three cases, the diagnosis is often missed. All the cases presented with vague abdominal symptoms, which are common in pregnancy anyway. Only one case was correctly diagnosed before surgery by ultrasound scan. For the two cases in the second trimester as expected the fetuses did not survive. The one advanced pregnancy had a good perinatal outcome. Maternal morbidity and mortality usually results from perioperative hemorrhage from the placental attachment site. The most important aspect of management is the management of the placenta. In the two cases with second trimester pregnancies, it was possible to remove the placentas, even though blood loss was significant, hemostasis was achieved at surgery. All three mothers recovered well and survived. <\/jats:p>","DOI":"10.2217\/whe.15.3","type":"journal-article","created":{"date-parts":[[2015,6,23]],"date-time":"2015-06-23T13:49:30Z","timestamp":1435067370000},"page":"275-279","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":6,"title":["Advanced Abdominal Ectopic Pregnancy: Lessons from Three Cases from Zimbabwe and a Literature Appraisal of Diagnostic and Management Challenges"],"prefix":"10.1177","volume":"11","author":[{"given":"Muchabayiwa F","family":"Gidiri","sequence":"first","affiliation":[{"name":"Academic Department of Obstetrics & Gynaecology, University of Zimbabwe College of Health Sciences, Parirenyatwa University Hospital, Mazowe Street, PO Box A178, Avondale Harare, Zimbabwe"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miriam","family":"Kanyenze","sequence":"additional","affiliation":[{"name":"Mutare Provincial Hospital, Department of Obstetrics & Gynaecology, PO Box 30, Mutare, Zimbabwe"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2015,5,1]]},"reference":[{"key":"bibr1a-WHE.15.3","unstructured":"Papers of special note have been highlighted as:"},{"key":"bibr2a-WHE.15.3","unstructured":"of interest; \u2022\u2022 of considerable interest"},{"issue":"5","key":"bibr1-WHE.15.3","first-page":"549","volume":"10","author":"Crawford JD","year":"1957","journal-title":"Obstet. Gynecol."},{"issue":"4","key":"bibr2-WHE.15.3","first-page":"1087","volume":"8","author":"Nkusu ND","year":"2008","journal-title":"Rural Remote Health"},{"key":"bibr5a-WHE.15.3","unstructured":"This is a large case series."},{"key":"bibr3-WHE.15.3","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9378(16)35733-7"},{"key":"bibr4-WHE.15.3","doi-asserted-by":"publisher","DOI":"10.1016\/B978-0-7020-3120-5.00025-4"},{"key":"bibr5-WHE.15.3","doi-asserted-by":"publisher","DOI":"10.1111\/tog.12109"},{"key":"bibr9a-WHE.15.3","unstructured":"Provides an excellent update on diagnosis and management options."},{"key":"bibr6-WHE.15.3","doi-asserted-by":"publisher","DOI":"10.1007\/BF02942151"},{"key":"bibr11a-WHE.15.3","unstructured":"This describes a series of cases and their outcomes from Zimbabwe a similar setting as the above three cases."},{"key":"bibr7-WHE.15.3","doi-asserted-by":"publisher","DOI":"10.1186\/1752-1947-7-10"},{"key":"bibr13a-WHE.15.3","unstructured":"Describes an advanced abdominal pregnancy with delivery of a live baby."},{"issue":"4","key":"bibr8-WHE.15.3","first-page":"195","volume":"3","author":"Nwobobo EI","year":"2004","journal-title":"Ann. Afr. Med."},{"key":"bibr9-WHE.15.3","doi-asserted-by":"publisher","DOI":"10.1089\/jwh.2009.1704"},{"key":"bibr16a-WHE.15.3","unstructured":"This is also an experience from low resource setting with highlights on perinatal and maternal mortality."},{"key":"bibr10-WHE.15.3","doi-asserted-by":"publisher","DOI":"10.1515\/JPM.2007.075"},{"issue":"1","key":"bibr11-WHE.15.3","first-page":"24","volume":"41","author":"Zvandasara P","year":"1995","journal-title":"Cent. Afr. J. Med."},{"key":"bibr19a-WHE.15.3","unstructured":"Describes an experience from the same setting."},{"key":"bibr12-WHE.15.3","doi-asserted-by":"publisher","DOI":"10.1080\/00016340701434476"},{"key":"bibr13-WHE.15.3","doi-asserted-by":"publisher","DOI":"10.4076\/1752-1947-3-7382"},{"key":"bibr22a-WHE.15.3","unstructured":"Discusses the use of preoperative methotrexate to minimize blood loss at surgery."},{"key":"bibr14-WHE.15.3","doi-asserted-by":"publisher","DOI":"10.1002\/jcu.1870090706"},{"key":"bibr24a-WHE.15.3","unstructured":"Outlines diagnostic features that must be identified to improve sonographic diagnosis."}],"container-title":["Women's Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.2217\/WHE.15.3","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.2217\/WHE.15.3","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.2217\/WHE.15.3","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,10]],"date-time":"2025-03-10T16:05:06Z","timestamp":1741622706000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.2217\/WHE.15.3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,5]]},"references-count":24,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2015,5]]}},"alternative-id":["10.2217\/WHE.15.3"],"URL":"https:\/\/doi.org\/10.2217\/whe.15.3","relation":{},"ISSN":["1745-5057","1745-5065"],"issn-type":[{"value":"1745-5057","type":"print"},{"value":"1745-5065","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,5]]}}}