title: A pre-operatively diagnosed advanced abdominal pregnancy with a surviving neonate: a case report.
abstract: BACKGROUND
  Abdominal pregnancy is a rare form of ectopic pregnancy with a high rate of maternal and fetal complications. Most of the reported cases are diagnosed in early trimesters, usually after presenting with complications. Advanced abdominal pregnancy poses a huge diagnostic and management challenge, particularly in low-income countries. A term abdominal pregnancy diagnosed pre-operatively and resulting in a surviving neonate is quite rare.
  
  
  METHODS
  A 35-year-old, para 2, unbooked, Ethiopian Somali woman presented with amenorrhea of 9 months' duration, abdominal pain, and painful fetal movements of 4 months' duration. Her physical examination revealed a uterus sized 36 weeks' gestation with easily palpable fetal parts. Her laboratory test results were unremarkable except for mild anemia. Her ultrasound findings were suggestive of abdominal pregnancy. Laparotomy was done to salvage an alive healthy neonate from the peritoneum with removal of placenta implanted on the right broad ligament. The mother had a smooth post-operative course.
  
  
  CONCLUSIONS
  An advanced abdominal pregnancy diagnosed pre-operatively with delivery of a surviving neonate is rare. A high index of suspicion and thorough clinical and ultrasound evaluation are crucial to making an early diagnosis. This is particularly important in areas where advanced imaging technologies are not readily available. Timely surgical intervention is imperative to avert maternal and fetal complications.
authors.affiliation: Department of Obstetrics & Gynecology, Karamara Regional Referral Hospital, P.O. Box 238, Jigjiga, Somali Regional State, Ethiopia. wondgu@yahoo.com.
authors.forename: Wondimu
authors.initials: W
authors.lastname: Gudu
authors.affiliation: Department of Obstetrics & Gynecology, Saint Paul's Hospital Millennium Medical College, P.O. Box 143079, Addis Ababa, Ethiopia. delayehu@gmail.com.
authors.forename: Delayehu
authors.initials: D
authors.lastname: Bekele
mesh_terms: D000005:Abdomen / Q000000981:diagnostic imaging / Q000601:surgery*; D015746:Abdominal Pain; D000328:Adult; D036861:Delivery, Obstetric; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007813:Laparotomy; D011247:Pregnancy; D011256:Pregnancy Outcome; D011263:Pregnancy Trimester, Third; D011269:Pregnancy, Abdominal / Q000175:diagnosis*; D014463:Ultrasonography