International Clinical and Medical Case Reports Journal (ISSN: 2832-5788) | Volume 4, Issue 6 | Case Report | Open Access
: Ananya Das*
Department of Obstetrics and Gynaecology, NEIGRIHMS, Shillong, Meghalaya, India
*Correspondence to: : Ananya Das
Fulltext PDFIntroduction: Ectopic pregnancies are a major cause of morbidity and mortality in the reproductive age group women. It is the implantation of the blastocyst in sites other than the endometrial cavity. An abdominal pregnancy is implantation of the fetus in the peritoneal cavity, excluding the tubes, ovaries and intraligamentous pregnancies.
Case report: A 28-year-old woman G3P2L2 attended the Emergency Department with the complaints of amenorrhoea for two months, abdominal distension and pain abdomen. She was pale with period of gestation of 12 weeks 2 days. On per abdomen examination a firm mass of 18-20 weeks felt, with irregular surface and restricted vertical mobility. An ultrasound scan showed features suggestive of ovarian/fimbrial ectopic pregnancy with no intrauterine gestational sac. A well-defined heterogenous lesion noted in right adnexa and Pouch of Douglas with surrounding echogenic structure suggestive of placental tissue, with macerated fetal head of bi-parietal diameter corresponding to 14 weeks of gestation. MRI also revealed the same picture. On exploratory laparotomy, hemoperitoneum of 700 ml was seen along with the fetus in peritoneal cavity. A rent was seen on the posterior surface of right fallopian tube with adherent products of conception evident on the inner surface. Bilateral ovaries were within normal limit.
Discussion: Abdominal pregnancy is an uncommon obstetric condition associated with significant risks for both the mother and baby. Its symptoms can vary widely, including irregular bleeding, abdominal pain, nausea, vomiting, and digestive disturbances such as flatulence, constipation, or diarrhoea. In some cases, small fetal parts may be felt through the vaginal fornices or observed outside the uterus. Diagnosis can be challenging due to its atypical presentation, often leading to delays. Typically, a secondary abdominal pregnancy arises after the early rupture of a tubal ectopic pregnancy [2]. Medical treatment for abdominal pregnancy is considered when surgical intervention poses a high risk of severe hemorrhage, particularly in cases where the pregnancy is located in the liver or spleen. Surgical intervention remains the primary treatment for ectopic abdominal pregnancy. Laparotomy is often preferred over laparoscopic surgery due to the risk of severe perioperative hemorrhage, which can be difficult to control at the implantation site.
Conclusion: Diagnosing and managing abdominal pregnancy requires a high level of clinical suspicion, as its symptoms can often mimic other conditions. Given its rarity and potential complications, vigilance is crucial in identifying signs early to prevent severe maternal risks. Clinical correlation-which involves comparing symptoms with imaging findings-is essential for confirming the diagnosis.
Ananya Das, Sukalyan Halder, Anusuya Sarma, Khulakpam Rimabati, Donboklang Lynser, Pranjal Kalita. Abdominal Pregnancy Secondary to Ruptured Tubal Ectopic. Int Clinc Med Case Rep Jour. 2025;4(6):1-8.