Abdominal Ectopic Pregnancy: A Diagnostic Dilemma

Abstract

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.