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No room in the womb

Lourdes I St George and John St George
Med J Aust 2002; 176 (11): 558.

A 34-year-old woman (gravida 5, para 2) presented to the Government Hospital in Katsina, northern Nigeria, in 1973. She was in labour and had had no antenatal care. She successfully delivered a live 3.2 kg infant.

A 14 cm right adnexal pelvic mass was noted postnatally. An x-ray and hysterosalpingogram (see picture) performed four months after the birth showed the calcified remains of an extrauterine pregnancy. The woman stated that four years earlier she had missed her periods and had consulted a "bush doctor" (local herbalist) about abdominal swelling and pain. The herbs he prescribed to rub on her abdomen had eased the pain, and her periods had returned after seven months.

The mass was easily removed from the omentum at subsequent laparotomy. Histology confirmed an advanced lithokelyphopaedion (ie, calcified fetus, membranes and placenta).

Lourdes I St George, LRCPS, FRCOG, FRACOG, Obstetrician and Gynaecologist
John St George, FRCS, FRCOG, FRACOG, Obstetrician and Gynaecologist (deceased)
Suite4/36 Belmore Street, Burwood, NSW, Australia.