Anesthesia Management of a Case of Abdominal Pregnancy Discovered Intraoperatively During an Emergency Cesarean Section: A Rare and Challenging Case

We present the anesthesia management of a rare case of an abdominal pregnancy discovered intraoperatively in a 30-year-old primigravida at presumed full term, who presented to the emergency department at our hospital with abdominal pain and fever. The patient presented for emergency cesarean section due to fetal distress. Spinal anesthesia was given per our hospital protocol. Intraoperative findings revealed a live abdominal pregnancy, with an intact gestational sac located on the left posterior uterine aspect, involving the entire fallopian tube, ovary, and infundibulopelvic ligament. After evaluating the surgical findings, the Obstetrician decided to leave the placenta in situ due to the extensive vascular supply. During this time, general anesthesia was given, as the patient started to bleed, and she needed to be resuscitated. The patient underwent surgical and intensive care management, including major transfusion, and was discharged in stable condition. This case highlights the diagnostic and anesthetic challenges of advanced abdominal pregnancies and the importance of multidisciplinary care.