A Potential Gynaecological Disaster that became Joy: A Case of Misdiagnosed Abdominal Ectopic Pregnancy with Live Baby at Term

Abstract

Background
The incidence of abdominal pregnancy is considerably lower than that of other forms of ectopic pregnancy and becomes life-threatening when it occurs. It has a high maternal mortality rate and foetal mortality rate; however, some abdominal ectopic pregnancies have been carried to term.

Case Presentation
We present a case of a 30-year-old G2P1+0, 1 alive woman who presented at our health facility at a gestational age of 37 weeks following a fall at home while taking her bath. She underwent an emergency caesarean section due to suspected placental abruption and transverse lie with a live foetus. However, the intra-operative findings revealed an abdominal ectopic pregnancy with a healthy female neonate. The placenta was attached to the uterine fundus and the greater omentum. An omentectomy was performed without compromising the blood supply to the bowels. Also, the loose membranous attachment to the uterine fundus was carefully excised and replaced with a suture. Both the patient and her baby girl were discharged home on the seventh day post-operation without complications. No gross congenital anomaly was detected on the baby.

Discussion
Live neonate in abdominal ectopic gestation is a rare occurrence, and a high index of suspicion with early diagnosis of abdominal ectopic pregnancy is necessary to avoid a potential maternal disaster. Fortunately, our patient had a favourable outcome despite the missed diagnosis.

Conclusion
There is a need for improved health resource allocation with training and retraining of radiologists and non-radiology professionals involved in obstetric ultrasound to avoid misdiagnosis, as it occurred in this case.