{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T12:06:22Z","timestamp":1791893182899,"version":"4.3.4"},"reference-count":35,"publisher":"BMJ","issue":"9","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2023,9,14]]},"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:p>An ectopic pregnancy (EP) accounts for 1\u20132% of all pregnancies, of which 90% implant in the fallopian tube. An abdominal ectopic pregnancy (AEP) is defined as an ectopic pregnancy occurring when the gestational sac is implanted in the peritoneal cavity outside the uterine cavity or the fallopian tube. Implantation sites may include the omentum, peritoneum of the pelvic and abdominal cavity, the uterine surface and abdominal organs such as the spleen, intestine, liver and blood vessels. Primary abdominal pregnancy results from fertilisation of the ovum in the abdominal cavity and secondary occurs from an aborted or ruptured tubal pregnancy. It represents a very rare form of an EP, occurring in &lt;1% of cases. At early gestations, it can be challenging to render the diagnosis, and it can be misdiagnosed as a tubal ectopic pregnancy. An AEP diagnosed &gt;20 weeks\u2019 gestation, caused by the implantation of an abnormal placenta, is an important cause of maternal\u2013fetal mortality due to the high risk of a major obstetric haemorrhage and coagulopathy following partial or total placental separation. Management options include surgical therapy (laparoscopy\u00b1laparotomy), medical therapy with intramuscular or intralesional methotrexate and\/or intracardiac potassium chloride or a combination of medical and surgical management. The authors present the case of a multiparous woman in her early 30s presenting with heavy vaginal bleeding and abdominal pain at 8 weeks\u2019 gestation. Her beta-human chorionic gonadotropin (bHCG) was 5760\u2009IU\/L (range: 0\u20135), consistent with a viable pregnancy. Her transvaginal ultrasound scan suggested an ectopic pregnancy. Laparoscopy confirmed an AEP involving the pelvic lateral sidewall. Her postoperative 48-hour bHCG was 374\u2009IU\/L. Due to the rarity of this presentation, a high index of clinical suspicion correlated with the woman\u2019s symptoms; bHCG and ultrasound scan is required to establish the diagnosis to prevent morbidity and mortality.<\/jats:p>","DOI":"10.1136\/bcr-2022-252960","type":"journal-article","created":{"date-parts":[[2023,9,29]],"date-time":"2023-09-29T13:40:24Z","timestamp":1695994824000},"page":"e252960","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":18,"title":["Abdominal ectopic pregnancy"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5499-415X","authenticated-orcid":false,"given":"Louise","family":"Dunphy","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Leighton Hospital, Crewe, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"Boyle","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Leighton Hospital, Crewe, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nadia","family":"Cassim","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Leighton Hospital, Crewe, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ajay","family":"Swaminathan","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Leighton Hospital, Crewe, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2023,9,29]]},"reference":[{"key":"2025082709574666000_16.9.e252960.1","doi-asserted-by":"crossref","first-page":"487","DOI":"10.1016\/S0002-9378(42)90488-5","article-title":"Primary peritoneal pregnancy","volume":"44","author":"Studdiford","year":"1942","journal-title":"Am J Obstet Gynecol"},{"key":"2025082709574666000_16.9.e252960.2","doi-asserted-by":"crossref","DOI":"10.1016\/j.crwh.2021.e00288","article-title":"Ectopic pregnancy until proven otherwise even with a negative serum hCG test: a case report","volume":"30","author":"Kopelman","year":"2021","journal-title":"Case Rep Womens Health"},{"key":"2025082709574666000_16.9.e252960.3","doi-asserted-by":"crossref","DOI":"10.1186\/s12958-016-0201-x","article-title":"Abdominal ectopic pregnancy after in vitro fertilization and single embryo transfer: a case report and systematic review","volume":"14","author":"Yoder","year":"2016","journal-title":"Reprod Biol Endocrinol"},{"key":"2025082709574666000_16.9.e252960.4","doi-asserted-by":"crossref","first-page":"81","DOI":"10.4314\/gmj.v45i2.68933","article-title":"Term abdominal pregnancy with healthy newborn: a case report","volume":"45","author":"Baffoe","year":"2011","journal-title":"Ghana Med J"},{"key":"2025082709574666000_16.9.e252960.5","doi-asserted-by":"publisher","DOI":"10.1159\/000342997"},{"key":"2025082709574666000_16.9.e252960.6","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1016\/j.jmig.2014.06.008","article-title":"Primary omental pregnancy with secondary implantation into posterior cul-de-SAC: laparoscopic treatment using hemostatic matrix","volume":"22","author":"Watrowski","year":"2015","journal-title":"J Minim Invasive Gynecol"},{"key":"2025082709574666000_16.9.e252960.7","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1093\/qjmed\/hcy063","article-title":"Primary hepatic pregnancy","volume":"111","author":"Yin","year":"2018","journal-title":"QJM"},{"key":"2025082709574666000_16.9.e252960.8","doi-asserted-by":"publisher","DOI":"10.1097\/00006250-196805000-00009"},{"key":"2025082709574666000_16.9.e252960.9","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1023\/A:1014451932539","article-title":"Retroperitoneal subpancreatic ectopic pregnancy following in vitro fertilization in a patient with previous bilateral salpingectomy: how did it get there?","volume":"19","author":"Dmowski","year":"2002","journal-title":"J Assist Reprod Genet"},{"key":"2025082709574666000_16.9.e252960.10","first-page":"277","article-title":"Cocaine use as a risk factor for abdominal pregnancy","volume":"90","author":"Audain","year":"1998","journal-title":"J Natl Med Assoc"},{"key":"2025082709574666000_16.9.e252960.11","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1159\/000291922","article-title":"Does primary Omental pregnancy exist?","volume":"42","author":"Berghella","year":"1996","journal-title":"Gynecol Obstet Invest"},{"key":"2025082709574666000_16.9.e252960.12","first-page":"251","article-title":"Primary abdominal pregnancy. A case report","volume":"51","author":"Paternoster","year":"1999","journal-title":"Minerva Ginecol"},{"key":"2025082709574666000_16.9.e252960.13","doi-asserted-by":"crossref","first-page":"523","DOI":"10.1016\/0002-9378(58)90064-4","article-title":"Primary peritoneal pregnancy","volume":"76","author":"Cavanagh","year":"1958","journal-title":"Am J Obstet Gynecol"},{"key":"2025082709574666000_16.9.e252960.14","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1055\/s-2007-1004829","article-title":"A case of retroperitoneal ectopic pregnancy following IVF-ET in a patient with previous bilateral salpingectomy","volume":"25","author":"Iwama","year":"2008","journal-title":"Am J Perinatol"},{"key":"2025082709574666000_16.9.e252960.15","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000243774.14606.64"},{"key":"2025082709574666000_16.9.e252960.16","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMicm1111814"},{"key":"2025082709574666000_16.9.e252960.17","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1007\/s00404-022-06570-9","article-title":"Abdominal pregnancy: a case report and review of 17 cases","volume":"307","author":"Chen","year":"2023","journal-title":"Arch Gynecol Obstet"},{"key":"2025082709574666000_16.9.e252960.18","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1002\/uog.25","article-title":"Successful outcome of advanced abdominal pregnancy with exclusive omental insertion","volume":"21","author":"Varma","year":"2003","journal-title":"Ultrasound Obstet Gynecol"},{"key":"2025082709574666000_16.9.e252960.19","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1016\/j.pog.2013.03.005","article-title":"Embarazo Ectopica Primario en Epiplon. Reporte de Caso","volume":"57","author":"Aragon-Charry","year":"2014","journal-title":"Progresos de Obstetricia y Ginecolog\u00eda"},{"key":"2025082709574666000_16.9.e252960.20","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1007\/s13224-018-1156-y","article-title":"Full-term live secondary abdominal pregnancy: a rare case report","volume":"69","author":"Gurjar","year":"2019","journal-title":"J Obstet Gynaecol India"},{"key":"2025082709574666000_16.9.e252960.21","doi-asserted-by":"crossref","DOI":"10.1186\/1752-1947-7-10","article-title":"Full-term abdominal extra-uterine pregnancy complicated by post-operative ascites with successful outcome: a case-report","volume":"7","author":"Masukume","year":"2013","journal-title":"J Med Case Rep"},{"key":"2025082709574666000_16.9.e252960.22","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1055\/s-0034-1371749","article-title":"Conservative management of an advanced abdominal pregnancy at 22 weeks","volume":"4","author":"Marcellin","year":"2014","journal-title":"AJP Rep"},{"key":"2025082709574666000_16.9.e252960.23","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1016\/j.gyobfe.2003.05.002","article-title":"Diagnosis and current concepts of management of advanced abdominal pregnancy","volume":"32","author":"Beddock","year":"2004","journal-title":"Gynecol Obstet Fertil"},{"key":"2025082709574666000_16.9.e252960.24","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1055\/s-2007-970049","article-title":"Local treatment of ectopic pregnancy","volume":"25","author":"Raughley","year":"2007","journal-title":"Semin Reprod Med"},{"key":"2025082709574666000_16.9.e252960.25","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1159\/000291922","article-title":"Does primary omental pregnancy exist","volume":"42","author":"Berghella","year":"1996","journal-title":"Gynecol Obstet Invest"},{"key":"2025082709574666000_16.9.e252960.26","doi-asserted-by":"publisher","DOI":"10.1007\/BF01204950"},{"key":"2025082709574666000_16.9.e252960.27","first-page":"676","article-title":"First trimester abdominal pregnancy and Laparoscopic surgical treatment. 2 case reports of evolving abdominal pregnancy treated with Laparoscopy at 10 and 12 weeks","volume":"23","author":"Abossolo","year":"1994","journal-title":"J Gynecol Obstet Biol Reprod (Paris)"},{"key":"2025082709574666000_16.9.e252960.28","doi-asserted-by":"publisher","DOI":"10.1080\/00016340701434476"},{"key":"2025082709574666000_16.9.e252960.29","doi-asserted-by":"crossref","DOI":"10.1186\/s13256-016-0808-8","article-title":"Complicated abdominal pregnancy with placenta feeding off sacral plexus and subsequent multiple ectopic pregnancies during a 4-year follow up: a case report","volume":"10","author":"Patel","year":"2016","journal-title":"J Med Case Rep"},{"key":"2025082709574666000_16.9.e252960.30","doi-asserted-by":"crossref","first-page":"1133","DOI":"10.1111\/j.1447-0756.2010.01270.x","article-title":"Retroperitoneal ectopic pregnancy: is there any place for non-surgical treatment with methotrexate","volume":"36","author":"Okorie","year":"2010","journal-title":"J Obstet Gynaecol Res"},{"key":"2025082709574666000_16.9.e252960.31","first-page":"107","article-title":"Un caso de embarazo abdominal","volume":"26","author":"Faraj","year":"1958","journal-title":"Rev M\u00e9d Hond"},{"key":"2025082709574666000_16.9.e252960.32","doi-asserted-by":"crossref","first-page":"709","DOI":"10.7863\/jum.2003.22.7.709","article-title":"Minimally invasive management of 14.5-week abdominal pregnancy without laparotomy: a novel approach using percutaneous sonographically guided feticide and systemic methotrexate","volume":"22","author":"Mitra","year":"2003","journal-title":"J Ultrasound Med"},{"key":"2025082709574666000_16.9.e252960.33","doi-asserted-by":"publisher","DOI":"10.1159\/000110015"},{"key":"2025082709574666000_16.9.e252960.34","unstructured":"Kassam M . Abdominal pain in pregnancy. In: David KJ , Philips JS , Carl PW , et al ., eds. High risk pregnancy: management option. London: WB Saunders, 2007: 996\u20137."},{"key":"2025082709574666000_16.9.e252960.35","doi-asserted-by":"crossref","first-page":"5","DOI":"10.5348\/ijcri-2012-11-209-CR-2","article-title":"Advanced live intra-abdominal pregnancy with good Fetomaternal outcome: a case report","volume":"3","author":"Sharma","year":"2012","journal-title":"Int J Case Reports Images"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2022-252960","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T16:57:55Z","timestamp":1756313875000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2022-252960"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9]]},"references-count":35,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2023,9,29]]},"published-print":{"date-parts":[[2023,9]]}},"alternative-id":["10.1136\/bcr-2022-252960"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2022-252960","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,9]]}}}