Abdominal Ectopic Pregnancy: Surgical Management in Low-Resource Settings

Abdominal ectopic pregnancy (AEP) is a rare and potentially life-threatening condition in which a fertilized ovum implants within the peritoneal cavity outside the uterine structures. It accounts for approximately 1% of all ectopic pregnancies and poses significant diagnostic and management challenges. AEP is a rare but serious obstetric emergency requiring high clinical suspicion for early diagnosis. Prompt imaging and appropriate surgical intervention are crucial in preventing maternal morbidity and mortality. We hereby report a case of a 42-year-old Gravida5 Para4 Alive1, a 17-week pregnant woman from a remote rural area presented with shock and sudden lower abdominal pain for 5 hours. Abdominal ultrasound revealed an abdominal ectopic pregnancy with the fetus in the right iliac fossa. Due to hemodynamic instability, an emergency laparotomy was performed, revealing a 17-week male fetus in the peritoneal cavity with 1500 mL of hemoperitoneum. The placenta was attached to the right fallopian tube, necessitating a salpingectomy. Postoperative recovery was uneventful without complications. This case highlights the importance of considering AEP in differential diagnoses of atypical abdominal pain in pregnancy and underscores the role of multidisciplinary management for optimal patient outcomes.