An unusual postpartum ectopic pregnancy: A case report

Abstract

Introduction: Ectopic pregnancy (EP) is a life-threatening condition and a leading cause of maternal morbidity and mortality, particularly in the first trimester. While most cases occur in the fallopian tube, postpartum EP is rare and often difficult to diagnose due to its atypical presentation. Early detection is critical to prevent complications such as rupture and haemorrhage, especially in resource-limited settings where diagnostic tools are limited.

Case Report: We report a case of a 32-year-old multiparous woman who presented with acute lower abdominal pain and no vaginal bleeding, five months postpartum following a Caesarean section. She was breastfeeding and had no prior history of EP or other known risk factors. The clinical examination revealed lower abdominal tenderness, along with stable vital signs. An abdominopelvic ultrasound showed a complex adnexal mass with no intrauterine gestation, and serum β-hCG levels were elevated at 3074 IU/L. An emergency exploratory laparotomy confirmed a ruptured left fimbrial ectopic pregnancy with 550 mL of hemoperitoneum.

Conclusion: This case highlights the need for high clinical suspicion in postpartum patients presenting with unexplained abdominal pain. Early diagnosis and prompt intervention are crucial to reducing maternal morbidity and mortality, particularly in resource-limited settings.