A Case Report of Early Abdominal Pregnancy

Abdominal pregnancy, accounting for 1% of ectopic pregnancies, presents significant management challenges due to its associated morbidity and mortality. It can be categorized based on gestation and implantation site, with ultrasound being the primary diagnostic tool. However, MRI and diagnostic laparoscopy serve as confirmatory tests.

The following case report included a 36-year-old woman, 9-10 weeks amenorrheic, who presented with abdominal pain and vomiting but no vaginal bleeding. Her examination revealed revealed left lower quadrant tenderness. 

Ultrasound investigation showed a live abdominal pregnancy at 12 weeks, implanted on the left uterine surface. 

 After counseling, she opted for surgical termination. During a diagnostic laparoscopy, it was confirmed that the gestational sac was adherent to the omentum and bowel, leading to a conversion to laparotomy for safe adhesiolysis and excision of the entire gestational sac. 

Post-surgery, the patient experienced complications, including abdominal pain, fever, and bleeding, with a CT scan indicating a left ureteric injury. She underwent a retrograde double J urethral stent placement, which healed with conservative management.

In conclusion, abdominal pregnancy is rare and complex, posing significant diagnostic and management challenges. Thus, it necessitates urgent surgical intervention to mitigate risks such as intra-abdominal bleeding and organ injury. A multi-disciplinary approach is essential for effective treatment.

Source: Ndungu MM, Thing R, Sankaran S. A rare case of early abdominal pregnancy (EAP). J Case Rep Images Obstet Gynecol 2024;10(2):34–40.