A case report of a full term primary advanced extrauterine abdominal pregnancy

Abstract

Background:
Extra-uterine abdominal pregnancy is extremely rare and is frequently missed during antenatal care. This is a report of a full-term extra-uterine abdominal pregnancy in a grand multipara who had recently used progesterone-only contraceptive and had laparotomy with good maternal outcome.
Case presentation: A 35-year-old, grand multipara presented at term having been managed over the previous 2 days in a primary health care facility. A diagnosis of cervical dystocia with intrauterine fetal death was made, and she was taken for emergency Caesarean section under general anaesthesia. Intraoperatively, an intact uterus with the fetus lying in the abdomen and surrounded by an amniotic fluid-filled sac, was found. The baby was extracted uneventfully, and the placenta was delivered easily from its location in the pouch of Douglas, without serious haemorrhage. The mother subsequently made progressive recovery and was discharged home in good condition.
Conclusion: Primary abdominal pregnancy is the rarest type of ectopic pregnancy which requires a high index of clinical suspicion supported by radiological exploration to diagnose, but is so often missed that progression to advanced gestation will continue to grace the medical literature. Hence, there is need for continued vigilance for detection and appropriate management.