April 9th, 2020

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Undetected Abdominal Pregnancy Delivered at 25+3 Weeks’ Gestation: A Case Report
Authors:  Angela Rugino, M.D., Iman Alsaden, M.D., and Kathy Jones, M.D.
BACKGROUND: Abdominal pregnancies are exceedingly rare, often present with hemoperitoneum, and are associated with high maternal mortality.

CASE: A 31-year-old woman, gravida 6 para 4, presented at 25 + 3 weeks’ gestation with abdominal pain, shock, and fetal bradycardia. She was found to have hemoperitoneum and an amniotic sac in the abdomen with the placental bed adherent to the uterine fundus.

CONCLUSION: The majority of abdominal pregnancies are misdiagnosed or discovered at time of emergent presentation to the hospital. Ultrasound demonstrating abnormal or adherent placentation, loss of interface between the placenta and the uterine wall, or close proximity of the fetus to maternal bowel warrants further investigation to exclude life-threatening abdominal pregnancy. A high level of suspicion in a patient with multiple gastrointestinal complaints prenatally and suspicious ultrasound findings may result in more accurate diagnosis and decreased mortality in these patients.
Keywords:  abdominal pregnancy, diagnosis, ectopic pregnancy, ruptured ectopic, ultrasound
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