A rare case report of advanced secondary abdominal pregnancy of 22 weeks during COVID 19 pandemic

Patient blood tachycardia oxygen saturation On abdomen palpable foetal on right side of flank. Fetal heart fetal Doppler 1). Dull percussion with mild tenderness also present. Uterine contour not demarkable. On per vaginal examination cervix closed and bleeding absent. Her investigation showed Haemogobin Total leucocyte Counts Differential leucocyte Polymorphs Lymphocytes Monocytes-01, S. Alkaline S. S. Creatinine S. Electrolytes were normal. Her urgent departmental ultrasound was done to confirm the diagnosis. It shows single dead foetus 21.4 weeks lying above the level of umbilical part 2). One Unit blood was transfused pre Abstract Abdominal ectopic pregnancy is a life-threatening condition where the embryo or foetus is growing in the abdominal cavity outside the uterus excluding fallopian tube, ovary or broad ligament. It can be primarily located in the peritoneal cavity or secondary to a ruptured ectopic pregnancy or tubal abortion. We are presentencing here a rare case of advanced abdominal pregnancy (AAP) in a very young women. Very few cases are reported till now and there are no clear cut guidelines regarding management of advanced abdominal pregnancy. This case we received when Covid 19 pandemic was as at its peak, many hospital were shut down by order of government authorities as not having the facility of following covid protocol regarding screening and management and elective surgeries were also abandoned in India. On ultrasound there was a foetus of 22 weeks found in mothers left lumber/left hypochondrium outside the uterine cavity. Her urgent laparotomy was planned as patient may land up in catastrophe any time and managed successfully with good co-ordination and support of various teams from Microbiology, Surgery, Anaesthesia, Obstetrics and Gynaecology departments of Sarojini Naidu Medical College Agra, Uttar Pradesh India. This case report supports the importance of routine antenatal checkups and first trimester ultrasound which was missed by patient that again may be because of lack of awareness and terrific environment because of pandemic. Timely diagnosis and teamwork management also plays important role for such a life-threatening condition to avoid maternal morbidity and mortality.