Secondary abdominal pregnancy following silent uterine rupture of five-fold cesarean section scar during early pregnancy

L. Akman, B. S. Hursitoglu, E. Eminov, M. C. Terek, H. Yilmaz

Abstract: Abdominal pregnancy is a relatively infrequent form of ectopic pregnancy; its diagnosis is difficult even with the routine use of abdominal sonography in daily obstetrical practice. Secondary abdominal pregnancies are generally due to the intraperitoneal translocation of the fetus following a tubal rupture; they may also develop, however, as a result of a dehiscence resulting from rupture along the scar of a previous cesarean section or the rupture of a rudimentary horn. Abdominal pregnancy being generally asymptomatic, routine obstetrical history, physical examination and abdominal ultrasound may fail to elicit subjective elements that could allow a differential diagnosis from intrauterine pregnancy. Our paper presents the case of a patient of ours with a history of five cesarean sections, in whom the last pregnancy continued in the peritoneal cavity following a scar rupture, probably during the first trimester, and resulted in fetal death in the 22nd week.
Keywords: secondary abdominal pregnancy, uterine rupture, fetal death