Asymptomatic Primary Abdominal Pregnancy in the Second Trimester: A Rare Case Report

Aims: Abdominal pregnancy, especially at the second trimester, is a rare and life-threatening case with a high mortality rate for both mother and fetus [1,2]. An abdominal pregnancy is defined as a pregnancy that occurs in the peritoneal cavity outside the tube, ovary, or intra-ligamentous region, which can occur primarily or secondary. The researcher reported the case of primary abdominal pregnancy [1,3-5].

Presentation Case Report: Patients G4P1A2H1 at 25-26 weeks pregnant without complaint, had an ultrasound examination which showed fetus location in the left hypochondria region, with placenta implantation attached to the abdominal aortic area, this was confirmed by MRI that showed intraabdominal pregnancy. Operative laparotomy in this patient was performed, followed by dissection of placenta attachment to the sigmoid colon and omental mucosa. Bleeding was also found in the uterine fundus without any evidence of the discovery of uteroperitoneal fistulas in intraoperative. The results of histopathological examination showed an appearance of placental tissue with a non-specific chronic inflammatory process from the placenta implantation of the abdominal pregnancy in the posterior fundus.

Conclusion: This case report supports the importance of diagnostic competence of life-threatening conditions, especially in rare cases with less obvious manifestations, in order to reduce maternal and fetal morbidity and mortality.