Puerperal presentation of a living abdominal pregnancy.

Abstract

Abdominal and heterotopic pregnancies appear to be increasing in incidence. We report a case of puerperal presentation of a living heterotopic pregnancy in an African woman. The patient presented 6 days postpartum with fever and abdominal pain. The correct diagnosis of heterotopic pregnancy was not considered, and for 9 days she was treated for presumed puerperal sepsis. It was only upon abdominal x-ray that the diagnosis was made. The patient underwent laparotomy with delivery of a living male neonate weighing 2000 g. He subsequently died of respiratory failure on day 3 of life. Although still rare, the increasing incidence of abdominal pregnancies in both developed and developing countries mandates awareness of this diagnosis, particularly in pregnant or postpartum women presenting with abdominal pain.