Advanced Pregnancy Research Articles

The Remediable Metarteriole - Chorangioma

Chorioangioma is a benign, non-trophoblastic, vascular neoplasm arising from the placenta. Chorangioma is associated with features such as advanced maternal age, diabetes mellitus, hypertension, preeclampsia, multiple gestations or high-altitude pregnancy. The miniature, asymptomatic chorangioma is incidentally discovered whereas giant chorangioma exceeding >4 centimeters magnitude exemplifies adverse perinatal and foetal outcomes and is associated with intrauterine growth restriction (IUGR), polyhydramnios, preterm labour, arteriovenous shunts, foetal cardiomegaly or foetal heart failure, hydrops foetalis, foetal thrombocytopenia and maternal mirror syndrome. Tumefaction is composed of foetal capillaries circumscribed by stroma and trophoblastic tissue. Foci of tumor infarction, fibrosis, hyalinization, calcification and deposition of hemosiderin pigment are observed. Chorangioma requires a segregation from chorangiosis, chorangiomatosis, inflammatory myofibroblastictumor, Leiomyoma, placental infarct, intervillous thrombus or chorangiocarcinoma. Chorangioma or giant chorioangioma can be suitably discerned with ultrasonography. Treatment options such as draining excessive amniotic fluid or surgical intervention of chorioangioma with laser coagulation and electrosurgical maneuvers may be adopted.

A rare full-term delivery in a chronic peritoneal dialysis patient

We aimed to report the case of a 37 years old woman, caucasian, who got pregnant after seven months of dialysis initiation and had a full-term weeks successful delivery. We also reviewed and presented the reported cases of peritoneal dialysis pregnancies in the last 6 years. The patient started renal replacement therapy due to focal segmental glomerulosclerosis and chronic tubular nephritis. In the same year, she got pregnant and started pre-maternal care in the high-risk pregnancy program. Peritoneal dialysis prescription was adjusted according to the patient’s tolerance and laboratory parameters. No complications occurred during the first and second trimester. In the first quarter of the third trimester, an antihypertensive drug was initiated for maintenance of blood pressure. She delivered a healthy baby via spontaneous vaginal at 39 weeks. Birth was induced due to the advanced pregnancy time and the risk of worsening arterial pressure. Our experience showed that peritoneal dialysis is a viable option during pregnancy according to the patient's residual renal function and promotes a successful pregnancy period with the correct adaptations on peritoneal dialysis prescription. Collaboration and support amongst family, nephrologist and gynecologist doctors, multidisciplinary team and the patient are crucial to ensure treatment quality and successful outcomes.

The comparison of maternal and neonatal outcomes between planned and emergency cesarean deliveries in placenta previa patients without placenta accreata spectrum.

This study aims to investigate whether a significant difference exists in maternal and fetal outcomes between planned cesarean delivery (PCD) compared to emergency cesarean delivery (ECD) in placenta previa (PP) patients without placenta accreata spectrum (PAS) in a tertiary referral hospital. This retrospective cohort study included 237 singleton pregnant women who were diagnosed with PP without PAS at the time of delivery. PP patients who were delivered at the scheduled time were included in the PCD group. Patients with PP delivered in an emergency setting before the scheduled date were assigned to the ECD group. We recorded demographic and clinical characteristics, maternal and neonatal outcomes. Of the 237 patients who met the inclusion criteria, 157 patients (66.8%) underwent PCD, and 80 patients required ECD (33.2%). Patients' hospitalization and pre-discharge hemoglobin levels were significantly lower in the ECD group (11.25 ± 1.97 g/dL and 9.74 ± 2.09 g/dL, respectively) than in the PCD group (10.77 ± 2.67 g/dL and 9.27 ± 2.70, p = 0.002 and p = 0.004, respectively). While six patients (7.5%) were required intensive care unit (ICU) admission in the ECD group, no patient was required to follow up in ICU in the PCD group (p < 0.001). The hospital length of stay (LOS) was tended to be significantly longer in the ECD group (2.8 ± 0.7 days) than in the PCD group (2.4 ± 0.6 days, p < 0.001). Neonatal outcomes of birth weight, Apgar scores, NICU admission, and neonatal death were significantly better in the PCD group than in the ECD group. The PCD group has better maternal outcomes, including preoperative and discharge hemoglobin levels, ICU admission and hospital LOS, and better neonatal outcomes than the ECD group. Clinicians should pay regard to that scheduling the delivery to advanced pregnancy weeks has a failure possibility, and patients could not reach the scheduled day due to the emergency states.

A unique case of coexisting intrauterine and abdominal pregnancy which progress to term with a positive birth outcome

BackgroundThe term heterotopic pregnancy is defined as a uterine pregnancy coexisting with a second pregnancy in an extrauterine location. Spontaneous, full-term heterotopic pregnancy with alive birth is very rare. The diagnosis and management of such exceptionally unique case is difficult. When the patient presented with an advanced labor with no antenatal care follow up and with no risk factors is even more challenging for poorly equipped facilities like ours.Case presentationA 25 years old gravida 3, para 2 (both are alive) mother presented to the labor and delivery ward of Bele Primary Hospital, Southern Ethiopia with the complaint of pushing down pain of 18 h duration. Immediately after arrival, she gave birth to a 3300gm female neonate spontaneously. After delivery, an abdominal mass was recognized and manual exploration of the uterus was done to look for the presence of after coming second twin but the uterus was empty. On ultrasound examination, there was an alive fetus in transverse lie outside the uterus. With the impression of 2nd twin in a separate horn of bicornuate uterus and to rule out abdominal pregnancy, laparotomy was done. On laparotomy, there was abdominal pregnancy in the Pouch of Douglas with an intact amniotic sac. The sac was attached with the left broad ligament, left ovary, small bowel mesentery, and posterior wall of the uterus. The sac opened, a 1600gm alive female neonate with features of fetal growth restriction and left club foot was delivered. The placenta was detached spontaneously and removed without any complication.ConclusionsThe coexistence of spontaneous full-term intrauterine with advanced abdominal ectopic pregnancy is one of the rarest forms of heterotopic pregnancy. Every health professional should bear in mind that intrauterine and extrauterine pregnancy may happen simultaneously and it can progress to term without any symptoms. Ultrasound is the diagnostic method of choice but the existence of an intra-uterine pregnancy cannot rule out ectopic pregnancy. The life-threatening complication of abdominal ectopic pregnancy is bleeding from the detached placental site. Therefore, the decision to remove the placenta should be individualized.

30 Viable advanced abdominal pregnancy

Objective: Advanced abdominal pregnancy is a rare form of extrauterine gestation with a high morbidity and mortality which demands skilled management. Despite recent developments in antenatal care and imaging modalities, undiagnosed cases of advanced abdominal pregnancies are still reported. Case: A 25-year-old, married, gravida 2 para 1, woman presented to our hospital with diffuse abdominal pain. Her physical examination revealed stable vital signs, mild pallor, distended abdomen with a uterus size at 20 weeks’ gestation, and diffuse abdominal tenderness but no guarding or rigidity.

Expectations of pregnant women for antenatal care services and factors affecting anxiety severity during the COVID-19 pandemic.

We aimed to evaluate the difficulties pregnant women encountered while receiving health care, their demands for antenatal care, and their mental state during the COVID-19 pandemic. A total of 447 pregnant women were included in this cross-sectional study. The data were collected through a face-to-face questionnaire, which assessed participants' demographic, individual, and obstetric characteristics, their opinions regarding the COVID-19 pandemic, expectations from their antenatal care services, and their Beck Anxiety Inventory (BAI) scores. During the COVID-19 pandemic, it was determined that 17.2% of the pregnant women participating in our study could not go to antenatal follow-ups and almost half (45.9%) demanded that their follow-ups be reduced due to the risk of coronavirus transmission. The BAI scores were found to be significantly higher in participants with low-income levels, chronic diseases, those in the third trimester, those with high-risk pregnancy either previous or current, and those who got pregnant unintentionally. Young age, unintentional conception, advanced pregnancy week, previous high-risk pregnancy, and failure to receive regular antenatal care were independent variables that predicted moderate-severe anxiety in logistic regression analysis. In order to minimize the adverse effects of the COVID-19 pandemic on the mental health of pregnant women, it is important to develop support programs that contribute to the well-being of the mother and fetus by recognizing the pregnant women at risk in the antenatal period.

Histological changes and transglutaminase 2 expression in the oviduct of advanced pregnant cows

The oviduct is a dynamic organ that has not been assigned specific functions during advanced pregnancy. However, since changes in the oviductal epithelium during the estrous cycle are attributed mainly to variations in estradiol (E2) levels, and E2 levels increase along pregnancy, we hypothesized that advanced pregnant cows should present changes in the oviductal epithelium. In advanced pregnant cows, the oviducts showed higher leaf-like folds and lower mucosa width and epithelium height than those of cycling animals. Also, PAS-positive apical protrusions and TUNEL-positive extruded cytoplasmic material were observed in advanced pregnant cows. Oviductal fluid from advanced pregnant cows showed lower protein concentration than that from cycling cows. Transglutaminase 2 (TG2) was detected exclusively in oviductal fluid of pregnant cows but not in cells from any stage, whereas its mRNA was detected in different amounts in cells from all stages. This protein was identified by LC/MS-MS and its identity was corroborated by Western blot. The observations in histology of the epithelium and the presence of TG2 in oviductal fluid correlate with high levels of E2 in serum. In conclusion, important histological changes in the oviductal epithelium and secretion of TG2 to the oviductal fluid appear to be triggered by the high E2 levels exclusive of advanced pregnancy.

Trends in cleft palate incidence in the era of obstetric sonography and early detection

Background The effect of improvement in prenatal identification of cleft lip or palate (CL/P) on termination of pregnancy (TOP) worldwide is scarcely reported. Our aim was to assess changes in the prevalence of cleft palate attributed to the high access and availability of prenatal advanced screening and pregnancy termination in Israel. Methods A retrospective study was conducted on CL/P patients which were treated in our institute and born between January 2000 and December 2018. Clinical and demographic data were extracted from medical records. Data on TOP were collected based on accessible information from the Ministry of Health. Cleft palate severity was evaluated using the Veau Classification. Results The study was conducted on 258 patients. Higher incidence of Veau II and III was evident throughout the examined period (2000–2018). However, when evaluating the incidence per year, we found that the incidence of severe cases (Veau III and IV) decreased every year showing a major decline of 60% in the last decade, whereas mild cases (Veau type I and II) demonstrated a marked increase of 90%. Regarding the incidence of abortions in Israel, a decrease of 30% was observed in the last two decades, meanwhile a substantial increase was detected in the rate of abortions related to physical malformations of the fetus. Additionally, the number of late terminations due to physical malformations significantly increased in the last decade. Conclusions Significant decrease was observed in the incidence of severe cleft palate cases in the last decade. Concurrently, we found a substantial increase in percentage of abortions performed due to physical malformations. We suggest that these changes might be attributed to the accessibility of advanced prenatal screening and pregnancy termination in Israel under the social healthcare system.

Frequency of Abruptio Placenta in Women With Pregnancy-Induced Hypertension.

Background: Bleeding that takes place after premature separation of the normally situated placenta, usually after 20 weeks of pregnancy, is known as abruptio placenta. Factors increasing chances of abruptio placenta are advanced age pregnancy, parity, smoking, pregnancy-induced hypertension, pre-eclampsia, and previous incidence of abruptio. The objective of the study was to find the frequency of abruptio placenta in women with pregnancy-induced hypertension.Methods: This descriptive prospective study was conducted in the Department of Obstetrics and Gynaecology, Jinnah Postgraduate Medical Centre, Karachi, from January to July, 2021. Women of gestational age above 20 weeks were included. Patients with blood pressure ≥140/90mmHg were considered as having pregnancy-induced hypertension. Early separation of the normally placed placental from the uterine wall was defined as placental abruption with clinical signs of painful vaginal bleeding (concealed or revealed), uterine contractions, and non-reassuring fetal heart rate. Descriptive statistics were calculated. Stratification was done and the post-stratification chi-square test was applied. P-value ≤ 0.05 was taken as significant.Results: A total of 205 patients were included in the study. The mean age was 24.26±2.92 years. The mean gestational age was 30.82±3.22 weeks. The mean parity was 2.59±0.80 children. Mean systolic blood pressure was 148.48±5.99 mmHg and mean diastolic blood pressure was 94.85±3.05 mmHg. Bleeding was reported in 110 (53.7%) cases. Lower abdominal tenderness in 125 (60.5%) cases. Fetal heart rate was normal in 16.6% of the cases. Abruptio placenta was observed in 29 (14.1%) patients.Conclusion:Abruptio placenta is a life-threatening condition that occurs during pregnancy that can result in both maternal and fetal morbidity and mortality. Adequate and urgent intervention can result in a favourable outcome.

Clinical Characteristics and Outcomes of Coronavirus Disease 2019 (COVID-19) in Pregnant Women: A Propensity Score-Matched Analysis of Data From the COVID-19 Registry Japan.

BackgroundSeveral studies have investigated whether pregnancy is a risk factor for developing severe COVID-19; however, the results remain controversial. In addition, the information regarding risk factors for developing severe COVID-19 in pregnant women is limited.MethodsA retrospective cohort study analyzing the data from the nationwide COVID-19 registry in Japan was conducted. Propensity score matched analysis was performed to compare COVID-19 severity between pregnant and nonpregnant women. Multivariate analysis was also conducted to evaluate risk factors for developing moderate-to-severe COVID-19 in pregnant women.ResultsDuring the study period, 254 pregnant and 3752 nonpregnant women of reproductive age were identified. After propensity score matching, 187 pregnant women and 935 nonpregnant women were selected. A composite outcome of moderate-to-severe COVID-19 was more frequently observed in pregnant women than that of nonpregnant women (n=18, 9.6% vs. n=46, 4.9%; P=0.0155). In multivariate analysis, the presence of underlying diseases and being in the second-to-third trimester of pregnancy were recognized as risk factors for moderate-to-severe COVID-19 in pregnant women (odds ratio [95% confidence interval]: 5.295 [1.21-23.069] and 3.871 [1.201-12.477], respectively).ConclusionsPregnancy could be a risk factor for moderate-to-severe COVID-19 for women in Japan. In addition to the presence of comorbidities, advanced pregnancy stages may contribute to greater risks for developing moderate-to-severe COVID-19 in pregnant women.

Management of Cervico-vaginal and Rectal Prolapse in Goat during Advanced Pregnancy

An apparently healthy doe with a history of bright red protruding cervico-vaginal and rectal mass through the vulva and anus, respectively, and continuous straining efforts was successfully managed till kidding with Buhner sutures using silk under epidural anesthesia.

Influence of Age, Parity, and Fetuses’ Number on Blood Parameters in RembiEwes during Late Pregnancy in Semi-Arid zone, Algeria

Several nutritional problems can be observed in ewes with advanced pregnancy when energy demands related to fetal development increase, then can hurt ewes and their lambs during this period. The aim of our study was the assessment of hematological and some biochemical parameters changes in ewes during late pregnancy and the influence of age, parity, and fetuses number on the latter. In this study blood samples were collected from forty ewes of the Rembi breed during the end of pregnancy, housed

Abdominal pregnancy—a diagnosis never to miss

&lt;abstract&gt;&lt;sec&gt; &lt;title&gt;Background&lt;/title&gt; &lt;p&gt;Abdominal pregnancy is very rare, with only a few gynecologists being fortunate to encounter it all through their professional careers. It makes up only 1% of all ectopic pregnancies but has very high perinatal and maternal mortality of 95% and 18% respectively. Hemorrhagic and infectious complications account for these. Removal of the placenta at laparotomy is a big dilemma as torrential bleeding may ensue.&lt;/p&gt; &lt;/sec&gt;&lt;sec&gt; &lt;title&gt;Case&lt;/title&gt; &lt;p&gt;We report the case of an undergraduate teenager who was referred with features of septicemia and anemia following unsafe vaginal instrumentation by a patent medicine dealer (a person without formal training in pharmacy but sells orthodox medications on retail basis) in a bid to terminate an extrauterine pregnancy. Ultrasonography confirmed a nonviable abdominal pregnancy of 20 weeks.&lt;/p&gt; &lt;/sec&gt;&lt;sec&gt; &lt;title&gt;Result&lt;/title&gt; &lt;p&gt;She had exploratory laparotomy with the evacuation of the dead fetus and successful complete removal of the placenta. Her postoperative recovery was uneventful.&lt;/p&gt; &lt;/sec&gt;&lt;sec&gt; &lt;title&gt;Conclusion&lt;/title&gt; &lt;p&gt;In view of the grave complications like a pelvic abscess, disseminated intravascular coagulation and bowel obstruction that may accompany retention of the placenta in advanced abdominal pregnancy, optimal placental removal at surgery is recommended whenever feasible.&lt;/p&gt; &lt;/sec&gt;&lt;/abstract&gt;

Anaesthetic Management of a Patient with Advanced Abdominal Pregnancy, Intrauterine Foetal Death and Celiac Disease

Abdominal pregnancy is a rare form of ectopic pregnancy where implantation of fertilised ovum occurs in the abdominal cavity. If diagnosed late maternal and foetal mortality is very high. The major cause of death in abdominal pregnancy is haemorrhage. The case report is about a 31-year-old gravida two with 36 weeks of gestation period with Intrauterine Foetal Death (IUFD) and celiac disease. Celiac disease is a chronic malabsorptive disease of the small intestine occurring due to hypersensitivity to gluten ingestion. Due to chronic malabsorption, the patient presented with calcium deficiency. She also had lesions of dermatitis herpetiformis over the whole body sparing only the face. It is a rare case of advanced abdominal pregnancy with the IUFD, with celiac disease. The patient was managed successfully under general anaesthesia with preparedness for difficult airway management, securing wide bore peripheral cannulas, central venous cannulation and invasive blood pressure monitoring. Massive haemorrhage intraoperatively was managed with crystalloids, colloids, blood products and tranexamic acid. The intraoperative period was uneventful. The patient was extubated at the end of the surgery, and followed-up in a high dependency unit.

Advanced Abdominal Pregnancy at Full Term with Live Fetus Invading Colon Mesentery in a Patient with Relative Infertility, Case Report

Abdominal pregnancy is rare, it accounts for about 1% of ectopic pregnancies. It has a high misdiagnosis rate especially if the case is presented for the first time at advanced gestational age. In most of the published cases, abdominal pregnancies do not get to full term gestation and usually the end result is the extraction of a dead fetus or congenitally malformed live fetus. We report a case of undiagnosed advanced abdominal pregnancy at full term that was presented to our hospital for elective caesarean section.

A Study on Morphological Growth and Development of Swiss Albino Mice, Wistar Rat and Dunkin Hartley Guinea Pigs

Background: Baseline information on the morphological development of laboratory animals is very scanty. Hence the present study was undertaken to understand the morphological development of experimental animals. Methods: An experiment was conducted at Biogen animal facility, Bangalore in the year 2018 to study the morphological changes with regard to growth and developmental parameters in Swiss albino mice and Wistar rats and body weight in guinea pigs. Ten Swiss albino mice and Wistar rats in advanced pregnancy of similar age groups and comparable litter sizes in the previous kindlings were selected for the experiment, where as five guinea pigs males and females each were selected with same age group. During the study period, litter weight and size at birth and at weaning, time of initiation and completion (full growth of hair) of hair growth, time of opening of eyes and ears recorded in Swiss albino mice and Wistar rats whereas body weight at birth, 3rd day, 6th day, 9th day, 12th day and 15th were recorded in Dunkin Hartley guinea pigs. Result: The results of Swiss albino mice indicated that the average litter weight (grams) and litter size at birth ranged from 1.39 and 7.50 respectively. The average time taken from initiation and full growth of hair covering on body was 7.50 to 15.30 days. Eyes and ears opened at 7.90 and 8.20 days respectively. Average weight of male and female recorded at weaning (25 days) 19.38 and 15.12 respectively and the litter size at the weaning was 9.70 whereas, livability percent was recorded 87.81 at the end of the trial. The results of Wistar rats indicated that the average litter weight (grams) and litter size at birth ranged from 5.07 and 11 respectively. The average time taken from initiation to full growth of hair covering on body was 9 to 16.20 days. Eyes and ears opened at 12.20 days, average weight (grams) of male and female recorded at weaning (25 days) 78.03 and 63.09 respectively. The litter size at the weaning was 9.70. The livability percent was recorded 88.02 at the end of the trial. The results of Dunkin Hartley guinea pigs indicated that the average body weight (grams) of female at birth, 3rd day, 6th day, 9th day, 12th day, 15th (Weaning period) ranged from 94.88, 109.34, 123.94, 139.74, 152.14 and 166.66, respectively. On the other hand, average body weight (grams) of male at birth, 3rd day, 6th day, 9th day, 12th day, 15th (Weaning period) ranged from 145.38, 155.42, 170.50, 185.54, 200.64 and 215.7, respectively.

Spectral Doppler ultrasound in the placental development of Mangalarga Marchador mares

The aim of the study was to correlate the spectral index of the right and left uterine arteries with equine placental development in mares with advanced pregnancies. We examined 32 multiparous Mangalarga Marchador mares with gestation of 150–240 days. During pregnancy, the pulsatility index (PI) and resistance index (RI) of the uterine arteries were obtained using spectral Doppler ultrasonography, and the combined uteroplacental thickness was obtained monthly using B-mode ultrasonography. The combined uteroplacental thickness correlated with gestational time of up to 13 years of age, and the significant difference was observed from the sixth month onwards. The CUPT stayed within the ideal measurements for this breed and for this gestational period. There was no correlation of CUPT with PI, however a negative and significant correlation of the RI was observed. The resistance index differed significantly among age groups, and the RI of the left uterine artery tended to decrease in all age groups. Furthermore, only RI differed significantly between the medians of gestatinal age. The left PI dropped in older mares. Thus, there an increased blood perfusion in the uterine arteries of mares with advanced pregnancies and among different age categories during placental and fetal physiological development.

Treatment of COVID-19 disease in pregnancy and breastfeeding

The physiological and anatomical clinical characteristics of pregnant women make them susceptible to complications caused by coronavirus disease (COVID-19). Increased coagulation and risk of thromboembolic phenomena are common during pregnancy; they are further enhanced when associated with a thrombogenic pathology such as in COVID-19. The treatment of COVID-19 is controversial and limited, even for non-pregnant patients. During pregnancy, the options are even more restricted due to the teratogenicity of some drugs and anatomical and physiological difficulties, especially in advanced pregnancy in patients with respiratory failure. Therefore, the focus of treatment for pregnant patients should be centered on isolation, monitoring fetal and maternal vital signs, uterine activity, and general maternal-fetal well-being. The prescription of drugs and management orientation should be based on gestational age and maternal clinical conditions. The optimal type of delivery is guided by obstetric indications and COVID-19 disease severity. Breastfeeding should be encouraged with the use of masks and hand hygiene. The treatment of pregnant women with COVID-19 brings important peculiarities that should be considered in order to make better decisions for preserving the health of the mother and fetus.

Intra-Hepatic Cholestasis of Pregnancy and Its Consequences: A Review

Background: The most common cause of liver illness in pregnancy is intrahepatic cholestasis (IHCP). It has a varying incidence due to geographic variance; factors such as advanced age, multiple pregnancy, family history, and previous pregnancy cholestasis have demonstrated a higher prevalence in these patients. Cholestasis in pregnancy has an aetiology that is currently unknown. It usually occurs after ovarian hyperstimulation syndrome in early pregnancy and coincides with growing oestrogen levels in the second half of pregnancy [1]. The ABCB4 gene mutation is largely associated in a subtype of progressive familial intrahepatic cholestasis, where disease clustering in first-degree relatives increases hereditary predisposition. Itchy palms and soles with elevated liver enzymes and bile acids are the most common symptoms. Some of the reported maternal problems in these patients include preterm labour, HELLP syndrome, acute fatty liver of pregnancy, and postpartum haemorrhage [2]. There are no precise antenatal foetal monitoring tests that can predict foetal fatalities in the womb. To reduce perinatal death with expectant treatment beyond this gestation, it is recommended that a pregnancy be terminated near 36–37 weeks of pregnancy.

Undiagnosed advanced abdominal pregnancy: a case report

&lt;p class="abstract"&gt;Abdominal pregnancy is a rare form of extra-uterine gestation in which implantation occurs in the peritoneal cavity, unlike this case it rarely reaches advanced gestation and viability of fetal outcome are not commonly documented. Abdominal pregnancy accounts for about 1-2% of ectopic gestation. It is associated with poor fetal outcome and great morbidity and mortality due to heamorrhage especially in a low resource setting. We present an undiagnosed advanced case of abdominal pregnancy of a 30 yr old unbooked G2P1+0 (1A) with early ultrasound estimation of 37 weeks and 6 days. She presented with (abdominal) labour pains and ultrasound diagnosis of breech presentation, suspicion of a bicornuate uterus and intrauterine growth restriction. She was planned for emergency cesarean delivery on this basis but found advanced abdominal pregnancy, and subsequently on delivery had good maternal and fetal outcome. Abdominal pregnancy with live fetus is extremely rare, and requires a high index of suspicion, to avoid high risk of maternal morbidity and mortality and it is also imperative for all healthcare givers to localized pregnancy whenever they get in contact with a woman who has recently missed her period.&lt;/p&gt;