Late abdominal pregnancy in a post-conflict context: case of a mistaken acute abdomen - a case report.
BMC Pregnancy Childbirth 2020;
20:238. [PMID:
32321457 PMCID:
PMC7178592 DOI:
10.1186/s12884-020-02939-3]
[Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Accepted: 04/13/2020] [Indexed: 11/23/2022] Open
Abstract
Background
Abdominal pregnancies have been reported in both high-income countries as well as low- and middle-income countries. They are frequently missed in routine antenatal care in resource-limited settings and delayed diagnosis is usually associated with poor fetal and maternal outcomes including death. This case report is among the first from eastern Democratic Republic of Congo (DRC), a post-conflict region.
Case presentation
In this case study, we present a 25 year-old primigravida patient referred to HEAL Africa hospital for management of an acute abdomen at 33-weeks gestation. Her chief complaint was severe abdominal pain associated with each fetal movement for a period of 1 week prior to admission. A diagnosis of peritonitis was made. Emergency laparotomy revealed a normal live 2 kg baby with placental implantation on the greater omentum and small intestine mesentery. The placenta was not removed. Both maternal and fetal outcomes were good.
Conclusion
Abdominal pregnancy with a normal live fetus at such an advanced gestational age is rare. This case reminds clinicians that abdominal pregnancy remains a differential diagnosis for painful fetal movements.
Collapse