Diagnosis and management of abdominal pregnancy - A case report

BACKGROUND: Abdominal pregnancy is a rare obstetric emergency, occurring in 1 in 10,000 pregnancies. CASE: An 18-year-old woman, gravida 3, para 1, presented for evaluation of an abnormal level of maternal serum alpha-fetoprotein. Transabdominal ultrasound examination revealed absence of amniotic fluid with limited imaging ability. Transabdominal amnioinfusion was done to better visualize the fetus. A small uterus was seen in the pelvis, and an abdominal pregnancy was identified with the placenta attached anteriorly over the right pelvic sidewalls. After delivery of the fetus, the placenta was left in situ. The patient recovered postoperatively and was doing well a year after the procedure. A 12 x 10-cm mass remains over the right pelvic sidewall without detectable Doppler blood flow. CONCLUSION: State-of-the-art imaging and prenatal diagnostic techniques allowed correct diagnosis, adequate preparation and optimal management of this dangerous condition.