Introduction: Abdominal pregnancy is a rare form of ectopic pregnancy with very high maternal and fetal morbidity and mortality. A high index of suspicion is crucial for prompt diagnosis and management especially in low-resource countries.
Case presentation: A 32-year-old gravida III para II Amhara woman presented with shortness of breath and progressive abdominal distension and pain. An emergency laparotomy was performed with the impression of abdominal pregnancy. Intraoperatively, the fetus was seen in an intact amniotic sac in her abdomen, her uterus was ruptured at the fundus and the placenta was extensively adhered to the edge of the ruptured site. The patient and neonate progressed well and were discharged.
Conclusions: Term abdominal pregnancy is an extremely rare diagnosis and requires a high index of suspicion. The life-threatening complication is bleeding from the detached placental site. A thorough examination of the newborn is important to rule out congenital anomalies.