Advanced abdominal pregnancy with successful live newborn: a case report

INTRODUCTION: Abdominal pregnancy is a rare type of ectopic pregnancy, and it is associated with high morbidity and mortality. Its diagnosis is very challenging to establish, most often in an acute setting, leading to a high percentage of fetal and maternal morbidity and mortality. CASE PRESENTATION: We present the case of a 27-year-old G2P1001 with abdominal pregnancy at 35 weeks 3 days who presented with painful fetal movements. She consulted the district hospital initially, where she was misdiagnosed and reassured as having a normal, evolving pregnancy. Later, with worsening of symptoms, she was referred to the tertiary hospital, where she was assessed, and ultrasonography findings revealed an empty uterus, a live fetus outside the uterine cavity, the placenta attaching to the fundus (ill-defined fundus), consistent with advanced abdominal pregnancy with a live fetus. Laparotomy was planned and performed, and a healthy newborn was born. The mother successfully recovered and was discharged uneventfully with her baby. CONCLUSION: Abdominal pregnancy poses a challenge in establishing a diagnosis, with a greater chance in cases of increased awareness. It requires a high index of suspicion for diagnosis and skills, as timely diagnosis leads to the correct treatment immediately and reduces morbidity and mortality. The Ministry of Health, in collaboration with the teaching universities, should prepare timely refresher courses for junior doctors to increase their awareness and enhance early ultrasonography to confirm the location of pregnancy for pregnant mothers.