• Jiahui Dai, Jin Chen, Xiaohan Xu, Ni Gao, and Yunfei Wang.
• Clinical Medical College, Jining Medical University, Jining, Shandong, China.
• Medicine (Baltimore). 2023 Sep 22; 102 (38): e35230e35230.

RationaleAbdominal pregnancy is a rare ectopic pregnancy and its diagnosis and treatment are more challenging than those of other ectopic pregnancies. Because of a variable pregnancy site, abdominal pregnancy is associated with an increased risk of fatal abdominal hemorrhage, and consequently, an increased risk of maternal death compared with intrauterine pregnancy.DiagnosesPelvic infundibulum ligament pregnancy complicated with massive hemorrhage.Patient Concerns42-year-old pregnant woman who did not undergo an obstetric examination during the first trimester presented with sudden abdominal pain during the second trimester. Abdominal pregnancy was confirmed after emergency treatment, causing difficulty in the comprehensive preoperative evaluation.Interventions: In order to save the patient life, we actively carried out surgical treatment.OutcomesThe patient recovered well after the operation and was discharged on the 11th postoperative day. Blood β-human chorionic gonadotropin (β-hCG) levels and routine blood test results were normal 1 month after the surgery, and the patient had recovered.LessonsSeveral challenges are encountered in the diagnosis of abdominal pregnancy with regard to insufficient economic, cultural, and medical resources. In case of ectopic pregnancies, surgery should be the first choice of treatment, and preparations of blood transfusion are essential to combat the risk of rapid hemorrhagic shock caused by placenta implantation in the infundibulum ligament of the pelvis. The operation must be performed by experienced obstetricians and gynecologists.Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.

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