Abdominal Pregnancy at 38 weeks with good maternal and perinatal outcome

  • Anjali Chaudhary Senior Consultant, Department of Gynecology and Obstetrics, Aarogya Hospital, Delhi, India
  • Umesh Varma Senior Consultant, Department of Medicine, Aarogya Hospital, Delhi, India
  • Nishchal Gupta Consultant, Department of Anesthesia, Aarogya Hospital, Delhi, India
  • Deepali Chaudhary Consultant, Department of Psychology, Aarogya Hospital, Delhi, India
  • Aditya Varma Medical Student, Sri Ramchandra Institute of Higher Education and Research, Chennai, India
  • Jahnvi Shanker Intern, Sri Ramchandra Institute of Higher Education and Research, Chennai, India
Keywords: Abdominal pregnancy, Hemorrhage, Laparotomy


Introduction: Abdominal pregnancy is very rare form of ectopic pregnancy, associated with high morbidity and mortality for both fetus and mother. An advanced abdominal pregnancy with good fetal and maternal outcome is therefore more extraordinary occurrence in modern developed world.

Case: We present a case of abdominal pregnancy which was an emergency diagnosis on OT table while performing elective LSCS for 38 weeks with breech with previous LSCS with normal documented prenatal sonographies (Fig S6, S7). It is extremely rare to first diagnose abdominal pregnancy at the time of elective caesarean section for another indication.

Management: Post delivery of baby by breech extraction, torrential bleed and massive hemorrhage from placenta adhering to bowel and omentum was big challenge. Provisional differential diagnosis was that of placenta percreta. This led team to follow emergency hemorrhage protocol of laparotomy, total abdominal hysterectomy under blood and blood products coverage with intravascular volume expanders.

At the time of laparotomy the fetus was located in the pelvis covered by the amniotic sac, with distortion of the entire right adnexa and invasion to the right parametrium and the right side pelvic wall. The placenta invaded the pouch of Douglas, the omentum and the bowel on right pelvic wall. Massive hemorrhage was a challenge and was dealt with successfully (fig 1). Injection methotrexate (50 mg) was used to expedite degeneration of the trophoblastic tissue in the residual placenta.


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N. Golz, D. Kramer, D. Robrecht, and H. Mast. Abdominal pregnancy: case report andreview ofliterature,”Geburtshilfe und Frauenheilkunde, vol. 44, no. 12, pp. 816–818, (1984). View at: PublisherSite | Google Scholar

E. L. Nwobodo, “Abdominal pregnancy: a case report. Annals of African Medicine, vol. 3, no.4, pp.185–196, (2004). View at: GoogleScholar

L. Badria, Z. Amarin, A. Jaradat, H. Zahawi, A. Gharaibeh, and A. Zobi, Full-term viable abdominal pregnancy: a case report and review." Archives of gynaecology and obstetrics 268.4 (2003): 340-342.

Dover, Richard W., and Martin C. Powell. Management of a primary abdominal pregnancy. American Journal of Obstetrics & Gynecology 172.5 (1995): 1603-1604.

Atrash HK, Friede A, Hogue CJ. Abdominal pregnancy in the United States: frequency and maternal mortality. Obstet Gynecol. 1987 Mar;69(3 Pt 1):333-7.

Rahman MS, Al-Suleiman SA, Rahman J, Al-Sibai MH. Advanced abdominal pregnancy--observations in 10 cases. Obstet Gynecol. 1982 Mar;59(3):366-72.

Binder, Douglas S. Thirteen-week abdominal pregnancy after hysterectomy. The Journal of emergency medicine 25.2 (2003): 159-161.

Fader, Amanda Nickles, et al. A 14-week abdominal pregnancy after total abdominal hysterectomy." Obstetrics & Gynecology 109.2 (2007): 519-521.

Baffoe P, Fofie C, Gandau BN. Term abdominal pregnancy with healthy newborn: a case report. Ghana Med J. 2011 Jun;45(2):81-3. doi: 10.4314/gmj.v45i2.68933.

Stevens, Cathy A. Malformations and deformations in abdominal pregnancy. American journal of medical genetics 47.8 (1993): 1189-1195.

American College of Obstetricians and Gynecologists. ACOG Practice Bulletin: Clinical Management Guidelines for Obstetrician-Gynecologists Number 76, October 2006: postpartum hemorrhage. Obstet Gynecol. 2006 Oct;108(4):1039-47. doi: 10.1097/00006250-200610000-00046.

Varma, R., L. Mascarenhas, and D. James. Successful outcome of advanced abdominal pregnancy with exclusive omental insertion. Ultrasound in Obstetrics and Gynecology: The Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology 21.2 (2003): 192-194.

How to Cite
Anjali Chaudhary, Umesh Varma, Nishchal Gupta, Deepali Chaudhary, Aditya Varma, & Jahnvi Shanker. (2022). Abdominal Pregnancy at 38 weeks with good maternal and perinatal outcome. Obs Gyne Review: Journal of Obstetric and Gynecology, 8(01), 1-5. Retrieved from https://obstetrics.medresearch.in/index.php/joog/article/view/151
Case Report