Abruption of Abdominal Pregnancy Following Blunt Trauma

Abdominal pregnancy represents a rare subset of ectopic pregnancy with a reported incidence around one per 10,000 live births. It is associated with high fetal and maternal morbidity and mortality. In this case, we describe a 25-year-old primigravida female who presented as a trauma activation with acute hypotension following blunt trauma to the abdomen and who was found to have a viable abdominal pregnancy with placental abruption. Given hypotension and non-reassuring fetal heart tones, the decision was made to take the patient to the operating room for emergent exploratory laparotomy and cesarean section. The placenta was severely adhered to a portion of small bowel, the appendix, and the right adnexa with an approximate 20% abruption. The placenta and adhered structures were removed. In pregnant patients presenting after blunt trauma with free intraabdominal fluid and hypotension, abdominal pregnancy with abruption should be considered as an unlikely differential.