Prolonged abdominal pregnancy incidentally discovered during cesarean section. A case report

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Abstract Background: Abdominal pregnancy is a rare pathology still encountered in developing countries due to insufficient medicalization. The clinical signs are polymorphic and nonspecific, which makes the diagnosis difficult and late. However, obstetric ultrasound plays a key role in early diagnosis. The objective was to share an experience of our service on this pathology and to show the need for early ultrasound diagnosis through optimal monitoring of pregnancy in our regions. Case presentation: We report a case of prolonged abdominal pregnancy in a 35-year-old black african women who consulted in our department for absence of active movements of the fetus with ten-month amenorrhea. The clinical examination and the ultrasound made it possible to evoke the diagnosis of a non-grogressing pregnancy of 39 weeks. The fetus was in a transverse position motivating the indication of a cesarean section. Intraoperatively, the fetus was discovered in the abdominal cavity with a placenta inserted into the left ovary. The uterus and right adnexa were normal. We performed an extraction of the macerated fetus weighing 2600g. The extraction of the placenta and membranes was without difficulty. The maternal prognosis was good. Conclusions: Abdominal pregnancy is still undiagnosed early in developing countries. Emphasis must be placed on raising awareness among pregnant women about quality prenatal care from conception, early obstetric ultrasound, continuous training of health professionals and modernization of the technical platform. The diagnosis of the location of the gestational sac must be made in any pregnant woman seen for the first time in the ultrasound room.

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