Successful anesthetic management of parturient with advanced abdominal pregnancy

Abdominal pregnancy is a rare form of ectopic pregnancy associated with high mortality and morbidity for both the fetus and the mother. It is often observed in developing nations with poor outcomes as most cases result in fetal demise. We present a 48 year old parturient diagnosed with abdominal pregnancy who elected to continue the pregnancy despite the communicated risks. The patient was admitted to the hospital at 24 weeks of gestational age for antepartum observation with the goal of surgical delivery at 28 weeks of gestation. General anesthesia was provided with multiple large bore intravenous access in anticipation of hemorrhage. The surgeons were able to deliver a viable neonate and the patient did well with moderate blood loss successfully managed with tranexamic acid, crystalloid fluid, and blood products. She was extubated immediately in the operating room and was discharged on postoperative day 4 with no issues.