Abdominal Ectopic Pregnancy: A Case Report of an Uncommon Complication of Pregnancy Without Prenatal Care

Ectopic pregnancy (EP) is a life-threatening condition requiring a high clinical suspicion. This diagnosis must be considered in all female patients of reproductive age presenting with abdominal pain or discomfort who may possibly be pregnant. Ectopic pregnancies occur in a small percentage of all pregnancies and are a significant cause of maternal morbidity and mortality. Abdominal ectopic pregnancy (AEP) is a rare and potentially fatal form of ectopic pregnancy where the implantation occurs in the abdominal cavity. We present the following case of a 23-year-old female who was transferred following an initial workup for abdominal pain and subsequently found to have an abdominal ectopic pregnancy at 37 weeks gestation. After transferring to our emergency department, the patient continued to have abdominal pain and her presenting FAST exam was positive for free fluid concerning for active hemorrhage and hematoma. Her clinical presentation was consistent with ruptured abdominal ectopic pregnancy, and she was taken to the operating room for emergent exploratory laparotomy and delivery. Her clinical course was complicated by adherent placenta and re-bleeding with significant hemoperitoneum requiring re-entry laparotomy and transfusion. We present the details of this case along with the diagnostic imaging and management of the rarely seen and life-threatening condition of secondary abdominal ectopic pregnancy (AEP).