Article Text
Summary
Second trimester abdominal ectopic pregnancies are rare and life threatening. Early diagnosis and treatment are paramount in reducing maternal morbidity and mortality. We describe an unusually late diagnosis of abdominal pregnancy despite multiple ultrasounds beginning in early pregnancy. A 28-year-old G2P1001 sought pregnancy termination at 22 weeks’ gestation after fetal anomalies were noted on an 18-week ultrasound during evaluation for elevated maternal serum alfa-fetoprotein. Due to abortion restrictions in her home state, she travelled over 500 miles for abortion care. During dilation and evacuation, suspected uterine perforation led to the finding of a previously undiagnosed abdominal pregnancy. At laparotomy, she underwent left salpingo-oophorectomy and removal of abdominal pregnancy and placenta. A multidisciplinary team approach was paramount in optimising the patient’s outcome. Abortion restrictions requiring travel away from the patient’s home community interrupted her continuity of care and created additional hardships, complicating management of an unexpected, rare and life-threatening condition.
- Medical Education
- Abortion
- Pregnancy
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Footnotes
Contributors KT was the lead author for this manuscript. She was responsible for initial planning and conception of this case report, one of several authors of the first draft and has helped with numerous revisions of the paper. NRB and KT are immediate mentors for the project. They oversaw and contributed to the first draft of the paper as well as have been editors for its newer revisions. KT and NRB have both been in contact with the patient during the writing process. EC was involved in drafting the discussion for the initial draft and has been a contributor to newer revisions of the paper. EE was the lead mentor. She and KT initially conceived of the idea of writing this up as a case report. She has been instrumental in terms of her mentorship and editing of every iteration of the manuscript. All four authors were directly involved in this patient’s care.
Competing interests None declared.
Patient consent Obtained.
Provenance and peer review Not commissioned; externally peer reviewed.