A case illustrating the continued dilemmas in treating abdominal pregnancy and a potential explanation for the high rate of postsurgical febrile morbidity.

BACKGROUND

Abdominal pregnancy is potentially highly morbid and often complicated by postoperative fever.

CASE

A 29-year-old gravida 2 para 0 presented with a 17-week size-demised abdominal pregnancy. We describe the continued difficulty in determining the timing and type of intervention. In addition, we found that the gestational sac was colonized by group B streptococcus at the time of surgery.

CONCLUSION

This case illustrates that preoperative colonization of the intra-abdominal gestational sac may contribute to postoperative febrile morbidity. We suggest treating patients with prophylactic antibiotics and avoiding spill of gestational sac contents into the peritoneal cavity. Placement of a sterile Foley bulb into the uterine cavity can confirm the extrauterine position of the pregnancy prior to undertaking surgery.