Undiagnosed advanced abdominal pregnancy with fetal demise: A case report

Abstract

Background: Abdominal pregnancy is rare and non-fatal. There are no specific associated symptoms, especially in cases of an uncomplicated type, which can reach term gestation.Case presentation: A 30-year-old gravida 2 para 1 presented to the labor ward as a referral with a confirmed intrauterine fetal demise (IUFD) by a transabdominal ultrasound at 36 weeks + 1 day. She was not in labor,had no drainage of liquor or per vaginal bleeding. A repeat scan confirmed the IUFD. Induction of labor was started but was unsuccessful. Intraoperatively, an abdominal pregnancy was found with a macerated stillbirth. The placenta was adherent to the small intestines and was left in the abdomen. She was managed conservatively with intravenous fluids and antibiotics. Her postnatal follow-up was unremarkable.Conclusion: Undiagnosed advanced abdominal pregnancies are common in low-resource settings, especially when antenatal care visits are not adhered to. Sensitization on antenatal care and ultrasound and magnetic resonance imaging, when accessible, are critical in the diagnosis of late-stage abdominal pregnancy.