Management Dilemma in Case of Abdominal Pregnancy: A Case Report

Introduction: Abdominal pregnancy is a rare form of ectopic pregnancy demanding high index of suspicion for diagnosis. We present a case of secondary abdominal pregnancy which was missed at a peripheral centre and referred to us with laparostomy wound after attempts were made to terminate it without proper diagnosis which resulted in excessive bleeding. Case Presentation: A 30-year-old primigravida was referred to us from a private clinic with a laparostomy wound. She had gone to the private clinic for termination of her 5-month-old pregnancy. Medical method was attempted initially failing which surgical evacuation was planned at second visit which resulted in excessive bleeding. The patient was opened up, fetus was removed from assumed uterine cavity and attempted to remove the placenta caused torrential bleeding. The abdominal cavity was packed and she was referred to a higher centre. Here she was taken up for re-exploration; ectopic sac was separated from neighboring structures, right cornu was found ruptured and was repaired. The patient also had wound dehiscence on post op day 7 for which secondary abdominal closure was done. Conclusion: Secondary abdominal pregnancy poses as a challenge to clinicians working in remote areas with limited diagnostic facilities. The condition may be life threatening if not handled meticulously.