A rare case of advanced abdominal pregnancy with good maternal and fetal outcome

Abstract

Advanced abdominal pregnancy is an uncommon and potentially precarious variant of ectopic pregnancy in which the fetus develops in the abdominal cavity. A 30-year-old multigravida presented at 33+5 weeks of gestation with abdominal pain. Ultrasonography revealed a single live fetus lying in the abdominal cavity, with the uterus seen separately. Previous ultrasonography done at 15 weeks of gestation was suggestive of intrauterine pregnancy. She underwent emergency laparotomy at 33+6 weeks, which confirmed secondary abdominal pregnancy with the placenta deriving its blood supply from the left uterine artery and omental vessels. A peripartum hysterectomy was performed. The postoperative period was uneventful, and both mother and baby were discharged after one week. Despite notable advancements in prenatal care and medical imaging technologies, abdominal pregnancies, even if advanced, may remain undiagnosed, emphasizing the necessity for healthcare professionals to maintain a heightened level of suspicion regarding this condition. If conservative management has to be sought, the case selection should be done carefully due to the high risk to both the mother’s and fetus’s life. There is a pressing need for the standardisation of treatment protocols in order to optimise maternal and fetal outcomes in abdominal pregnancy.