DOI: 10.36347/SJMCR.2019.v07i09.005

Pages: 564-566

Advanced abdominal pregnancy is a rare form of ectopic pregnancy with very high morbidity and mortality for both the mother and the fetus. Diagnosis and management can pose some difficulties especially in low-resource centers. We report a case of abdominal pregnancy with massive hemoperitoneum. A 40-year-old Moroccan woman, G3P3 (2 alive children), presented with shortness of breath and progressive abdominal distension and pain at 27 weeks’ gestation. Ultrasonography demonstrated massive intraperitoneal bleeding and identified the term of an abdominal pregnancy without fetal cardiac activity. An emergency laparotomy was performed. The dead male fetus was extracted uneventfully. The placenta which was implanted into the ruptured isthmus of the left fallopian tube was removed by salpingectomy. The patient was transfused with 6 units of packed red blood cells, and she was discharged from the hospital on the 10th postoperative day. Abdominal pregnancy poses special challenges to obstetricians working in remote areas with limited resources for diagnosis. A high index of suspicion is required in recognizing this condition in order to prevent,adverse maternal and fetal outcomes.