Late abdominal pregnancy in a post-conflict context: case of a mistaken acute abdomen - a case report

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...

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Main Authors: Justin Lussy Paluku (Author), Benjamin Kambale Kalole (Author), Cathy Mufungizi Furaha (Author), Eugenie Mukekulu Kamabu (Author), Gaspard Makambo Mohilo (Author), Benjamin Kasereka Kataliko (Author), Susan Andrea Bartels (Author)
Format: Book
Published: BMC, 2020-04-01T00:00:00Z.
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Summary: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.
Item Description:10.1186/s12884-020-02939-3
1471-2393