Abdominal ectopic pregnancy still a diagnostic dilemma: A case report

Abstract

Abdominal pregnancy is a very rare occurrence; however it poses great diagnostic and therapeutic challenges. We present a 30 year old unbooked G4P2+1(1alive) lady who was referred following failed attempt at both medical and surgical management of ultrasound scan confirmed intra uterine missed miscarriage at 17 weeks. She had multiple doses of vaginal misoprostol with no appreciable cervical changes, necessitating a suspicion of extrauterine gestation. A repeat TVS was done that showed abdominal pregnancy. She had exploratory laparotomy with finding of abdominal ectopic pregnancy with an intact amniotic sac located over the right adnexa with extension into the pouch of Douglas and the placenta attached to the jejunum all covered by omentum. Abdominal ectopic pregnancy still remains a diagnostic challenge despite availability of ultrasound. High index of clinical suspicion and early management with a multidisciplinary team is necessary to avert maternal morbidity and mortality.