Abdominal pregnancy is a rare event but is associated with significant morbidity and mortality. The incidence of abdominal pregnancy is 1 in 10 000 live births. We report a case on an abdominal pregnancy that presented at 17 weeks of gestation and was not picked up till then on previous ultrasound reports and was eventually diagnosed when presented as missed abortion with placental hemorrhage.The clinical presentation of abdominal pregnancy varies, and the diagnosis depends on a high index of suspicion. Ultrasonography is useful for early diagnosis of the condition. The treatment of the placenta is a matter of controversy. In general, expectant management is suggested. When the placenta is left behind, the use of prophylactic methrotrexate is advocated in some cases although expectant management with serial B-hCG monitoring has also shown to result in subsequent placental shrinkage. An awareness of abdominal pregnancy is very important for reducing associated morbidity and mortality.

Objective:To determine the effectiveness of manual vaccum aspiration in missed miscarriage of less than 12 weeks gestation.Place and duration of study: Department of Obstetric and gynecology, Fatima Memorial Hospital, Lahore for a period of 6 months from March 2012 to August 2012 and 87 patients with missed miscarriage were included in the study. In all patients evacuation was done by Manual Vacuum Aspiration (MVA). The data of each patient and outcome of procedure was recorded in a performa. Results:In this study MVA was 96.5% effective to evacuate the uterus up to 12 weeks gestation while in 3.5% cases procedure failed and further procedure was required to evacuate the uterus. Highest frequency of effectiveness was found in age group of between 15 and 30 years. Primiparous women had highest frequency of effective evacuation. MVA was 100% effective at gestational age between 8 and 10 weeks. Increased BMI was associated with incomplete evacuation. Conclusion:The present study shows that MVA is effective method to treat missed miscarriage of less than 12 weeks of gestation. In this study we concluded that there is an association between young patient age, low parity, early gestational age, low BMI and effectiveness of MVA.