Management of mid-term abdominal pregnancy: A rare case report and literature review

Abdominal pregnancy (AP) is a rare form of ectopic pregnancy. It is associated with significant maternal and fetal risks, including high rates of morbidity and mortality. The condition poses considerable therapeutic challenges, particularly in the mid to late stages of gestation. To date, there is no standardized treatment protocol for such cases. We describe a case of a 37-year-old woman, G2P1, who was diagnosed with a live 16-week AP. The patient underwent multidisciplinary treatment, including ultrasound-guided methotrexate injection into the fetal heart, lauromacrogol injection into the placenta, oral administration of mifepristone, and subsequent laparotomy to remove the fetus, placenta, and left fallopian tube. This approach successfully demised the fetus, reduced the placental blood supply, and created more favorable conditions for surgery. The patient recovered uneventfully post-surgery. This case illustrates the potential benefits of a combined therapeutic approach in successfully managing mid-term AP.