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

• 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.
• Subjects: article
• Online Access: Connect to this object online.
• Notes: 10.1186/s12884-020-02939-3; 1471-2393
• Keywords: Abdominal pregnancy; Painful fetal movements; Acute abdomen; Post-conflict; Gynecology and obstetrics; RG1-991
• Source: BMC Pregnancy and Childbirth, Vol 20, Iss 1, Pp 1-6 (2020)

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.