Secondary abdominal ectopic pregnancy

Abstract

Introduction: by definition, an abdominal pregnancy is that ectopic embryo implantation that occurs in the peritoneal cavity, and whose incidence varies between 1:10000 and 1:30000 pregnancies, being 7,7 times more lethal than the rest of the ectopic pregnancies.

Objective: to describe the case of a patient with secondary abdominal ectopic pregnancy.

Case presentation: a 22-year-old patient who came to the emergency room complaining of 20-week amenorrhea, pain in the hypogastrium, and scant vaginal bleeding with small clots. Pelvic and transvaginal ultrasound showed a uterus with heterogeneous endometrium without intrauterine gestation and a mixed image suggestive of a gestational sac with an embryonic outline of 13,1 weeks, without heartbeat. Emergency exploratory laparotomy confirmed an abdominal ectopic pregnancy secondary to the rupture of the left uterine horn. Subsequently, placental removal was performed from the portion corresponding to the uterus and Douglas cul-de-sac. The patient was discharged seven days after surgery with a satisfactory clinical course and no complications.

Conclusions: as the abdominal pregnancy has a higher mortality in relation to the rest of the ectopic pregnancies, it is a challenge for the obstetrician in advance. Its late diagnosis should constitute an alarm signal for health systems worldwide. Therefore, the subsequent result will depend on its effective and early management, and whose objective will always be aimed at reducing maternal morbidity and mortality due to this cause