A Macerated Advanced Abdominal Pregnancy Co-existing With a Normal Intra -Uterine Pregnancy: A Case Study

Abstract

An abdominal pregnancy is not a common occurrence reported sparsely in the literature. But what is even more uncommon is the finding of a dead and retained, supra hepatic, abdominal pregnancy co-existing with a live intra uterine pregnancy at different stages of development. This is an extremely rare case of a 22-year old multigravida, who presented with 6 months amenorrhoea, abdominal distension and difficulty in breathing. She had a previous history of a preexisting advanced abdominal pregnancy diagnosed a year earlier which had not been delivered. Evaluations revealed a viable intra-uterine gestation at 24 weeks, co-existing with a non-viable, sub-diaphragmatic/supra-hepatic abdominal pregnancy at term. She had the macerated abdominal pregnancy delivered at laparotomy and the intra-uterine pregnancy was left to continue. She developed Preeclampsia and eventually had pre-term premature rupture of membranes PPROM at 28 weeks of gestation with a live birth of a female fetus that weighed 800 grammes. There have been very few reports on advanced abdominal pregnancy and even more rarely, human superfetation in multiple pregnancy, but not a report on an intrauterine conception with a pre-existing advanced, abdominal ectopic pregnancy until now. This report is thus the first of its kind. We report an extremely rare case of a woman conceiving an intrauterine pregnancy, carrying it to the age of viability in the presence of a previously conceived, undelivered, dead, advanced abdominal pregnancy