title: Puerperal presentation of a living abdominal pregnancy.
abstract: BACKGROUND
  Abdominal and heterotopic pregnancies appear to be increasing in incidence.
  
  
  METHODS
  We report a case of puerperal presentation of a living heterotopic pregnancy in an African woman. The patient presented 6 days postpartum with fever and abdominal pain. The correct diagnosis of heterotopic pregnancy was not considered, and for 9 days she was treated for presumed puerperal sepsis. It was only upon abdominal x-ray that the diagnosis was made. The patient underwent laparotomy with delivery of a living male neonate weighing 2000 g. He subsequently died of respiratory failure on day 3 of life.
  
  
  CONCLUSIONS
  Although still rare, the increasing incidence of abdominal pregnancies in both developed and developing countries mandates awareness of this diagnosis, particularly in pregnant or postpartum women presenting with abdominal pain.
authors.affiliation: Department of Obstetrics and Gynecology, St. John's Hospital, Mzuzu, Malawi.
authors.forename: K E
authors.initials: KE
authors.lastname: Crabtree
authors.forename: B
authors.initials: B
authors.lastname: Collet
authors.forename: S J
authors.initials: SJ
authors.lastname: Kilpatrick
mesh_terms: D005260:Female; D006801:Humans; D049590:Postpartum Period; D011247:Pregnancy; D011269:Pregnancy, Abdominal