Full-Term, Unexpected, Abdominal Ectopic Pregnancy in a 38-Year-Old Patient With Leiomyomas

Abdominal ectopic pregnancy is a rare and life-threatening condition, often leading to severe maternal complications. Its diagnosis is frequently challenging due to nonspecific symptoms and reliance on ultrasound findings that may not always indicate abnormalities. Case reports for this type of pregnancy are limited due to its low incidence. We present a case of a 38-year-old patient from southern urban Mexico, undergoing her 3rd pregnancy. Around the due date, she was admitted to the obstetric emergency department, presenting with stabbing pain in the right lower extremity at the level of the thigh with perception of fetal movements and contracture of the right pelvic limb. After five hours without labor, an emergency cesarean section was performed. During intervention, the uterus (12 x 8 x 6 cm) was observed with the presence of a subserosa fibroid in the uterine fundus (1 cm), amniotic sac located in the abdominal cavity with normal amniotic fluid, and placenta with insertion in the posterior fundus, posterior aspect of the uterus and part of the sigmoid, with extension to the right broad ligament and distortion of the anatomy of the right appendix, which was removed with the help of surgery without complications. We reported a rare case of ectopic pregnancy, which remained unexpected until cesarean section, due to a single ultrasound report indicating uneventful pregnancy and a healthy fetus. We conclude that an ectopic pregnancy can progress almost uneventfully and result in a neonate without anomalies.