Full term abdominal pregnancy with live fetus, still an occurrence in contemporary obstetrics practice: a case report

Abstract

Abdominal pregnancy is an ectopic pregnancy in which the fetus develops in the peritoneal cavity. It is associated with significant morbidity and mortality. Advanced abdominal pregnancy
is a rarity and difficult to diagnose pre-operatively. The diagnosis of such condition can be missed pre-operatively despite the use of prenatal ultrasound scan. We present an advanced case of abdominal pregnancy A 38-year-old G₄ P_3⁰⁺ A3 was referred to us on 10^th June 2015 with history of 9 months amenorrhea and intermittent abdominal pain. She gave a history of vaginal bleeding, severe abdominal pain and fainting attack in the first trimester for which she was managed conservatively in a private hospital. Abdominal examination revealed a uterine size of 38 weeks with the fetus in breech presentation. On pelvic examination the cervix was closed, posterior and un-effaced. Abdominal ultrasound scan revealed a live singleton pregnancy with an average gestational age of 40 weeks in breech presentation. In view of the breech she was planned for lower segmentcaesarean section during which she was found to have an advanced abdominal pregnancy. Conclusion: Advanced abdominal pregnancy is rare and difficult to diagnose pre-operatively. High levelsof suspicion are required to diagnose this entity.