A case illustrating the continued dilemmas in treating abdominal pregnancy and a potential explanation for the high rate of postsurgical febrile morbidity

Background: Abdominal pregnancy is potentially highly morbid and often complicated by postoperative fever. Case: A 29-year-old gravida 2 para 0 presented with a 17-week size-demised abdominal pregnancy. We describe the continued difficulty in determining the timing and type of intervention, In addition, we found that the gestational sac was colonized by group B streptococcus at the time of surgery. Conclusion: This case illustrates that preoperative colonization of the intra-abdominal gestational sac may contribute to postoperative febrile morbidity, We suggest treating patients with prophylactic antibiotics and avoiding spill of gestational sac contents into the peritoneal cavity. Placement of a sterile Foley bulb into the uterine cavity can confirm the extrauterine position of the pregnancy prior to undertaking surgery.