Advancedsecondary Abdominal Pregnancy till Term: A Case Report

Introduction: Advanced abdominal pregnancy is a rare condition with high maternal & fetal morbidity as well as mortality. Inadequate placentation, unusual implantation &associated anomalies increase maternal &fetal morbidity and mortality. Diagnosis & management of advance abdominal pregnancy is always a challenge for obstetricians. Aims & Objectives: Management of rare case of advanced secondary abdominal pregnancy. Material & Methods: A 20yr young second gravida with full term gestation with history of previous L.S.C.S. with transverse lie & low lying placenta refered to our institute for emergency LSCS. Her last USG at 34wks showing single live intrauterine fetus in transverse lie with placenta previa. We avoided per vaginal examination in v/o central placenta previa. Decision of emergency L.S.C.S. was taken. After opening abdomen we got many surprises, after all obstacles we came out with successful outcome. Happily closed the abdomen with expression of victory. Results: With skillful and patient handling we were able to manage such a rare case with successful outcome in terms of mother as well as fetus even with complete removal of placenta. Conclusion: Advanced secondary abdominal pregnancy are rarely diagnosed clinically. Use of timely ultra sonography, intraoperative recognition, surgical skill, ready access to blood products, patiently taking decision about status of placenta are the cornerstone of successful management. Dreadful surprises can change in a remarkable unforgettable victory.