Unusual cause of abdominal pain in the second trimester in a primigravida: case report

Abstract

A 26-year-old primigravida, at 22 weeks gestation by dates, was admitted to our institution after having presented with a two-day history of abdominal pain and vaginal spotting. An abdominal ultrasound revealed an abdominal pregnancy with fetal demise at 20 weeks and an empty uterus. Intra-operatively, the placenta was noted to adhere to the posterior wall of the bladder and the fundus of the uterus. A macerated stillbirth with missing limbs was removed and the placenta left in place. The patient improved post-operatively and was later discharged, follow up serum B-HCG were noted to decline. We report this case since ectopic pregnancies are more common now, and therefore we need to highlight the importance of early scans to confirm viability and site of conceptus implantation.

Keywords: Abdominal pregnancy, Macerated, Abdominal pain