A woman walked into a remote island’s emergency room with stomach pain, then learned she was having an incredibly rare pregnancy, French doctors report.
The woman, 37, arrived at the rural emergency department after significant abdominal pain for ten days, doctors said in a case report published in the New England Journal of Medicine on Dec. 9.
Her doctors, one based on a French territory island off the coast of Madagascar and another based in Lyon, France, said the woman had a “gravid abdomen,” or the bump typically created when a person is pregnant.
The woman had been pregnant before, doctors said, carrying two children to full term and miscarrying a third.
Using an ultrasound, they noticed her endometrium, or lining of the uterus, had thickened as typical with pregnancy, but her uterus remained empty, according to the report.
Confused, the woman was taken for a MRI – and the results were shocking.
Sitting outside of her uterus and in her abdomen was a perfectly healthy placenta, and inside was a fetus, doctors said.
Based on the size and growth of the fetus, her doctors estimated the pregnancy to be 23 weeks along, nearly the end of the second trimester, according to the report.
The placenta, an organ that develops during pregnancy to surround a fetus and provide oxygen and nutrients, was attached to the woman’s peritoneum, a membrane that lines the abdominal cavity, instead of inside the uterus, doctors said.
Instead of the growth from the fetus creating a bump on the front of the woman’s body, the placenta was growing just above the sacral promontory, a bone on the back of the body that connects the bottom of the spine to the pelvis, according to the report.
Ectopic pregnancies, meaning a pregnancy that occurs outside the uterus, occurs in about 2% of pregnancies, according to the Cleveland Clinic. It is usually incredibly dangerous for the mother and baby.
Abdominal pregnancies are even more rare, only occurring in 1% of all ectopic pregnancies, according to a 2021 case report published by Baylor University Medical Center.
Knowing the risks, the woman’s doctors transferred her to another hospital where she remained for the next six weeks, according to the report.
When the fetus was 29 weeks along, her doctors performed a laparotomy, an abdominal surgery, to remove the fetus before it presented too high a risk of the woman bleeding out or the fetus dying.
The baby was successfully removed and placed in an intensive care unit, doctors said, and the placenta was partially removed to prevent bleeding before the rest was cut out 12 days later.
The mother was discharged from the hospital in good health 25 days later, and two months after the child was born, they were reunited with their mother and could go home, according to the report.
In the weeks following the rare case, the mother didn’t return for follow-up appointments and declined using contraception, doctors said.
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