Advanced abdominal pregnancy complicated by bilateral ureteral obstruction. A case report

A case of term abdominal pregnancy is reported. The patient was followed throughout pregnancy, but the diagnosis was made only at the time of laparotomy for elective cesarean section. The report exemplifies the ease with which the diagnosis of abdominal pregnancy can be overlooked and stresses the importance of considering this diagnosis in cases of high maternal serum alpha-fetoprotein. The management of the placenta is also discussed. In this case the retained placenta was managed successfully without intervention despite the unusual complication of bilateral ureteral obstruction. Additionally, the biochemical activity of the placenta was assessed by following the progressive decline of serum human chorionic gonadotropin over time.