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

Background: Abdominal pregnancy is potentially highly morbid and often comp licated by postoperative fever. Case: A 29-year-old gravida 2 para 0 presen ted with a 17-week size-demised abdominal pregnancy. We describe the contin ued difficulty in determining the timing and type of intervention, In addit ion, we found that the gestational sac was colonized by group B streptococc us at the time of surgery. Conclusion: This case illustrates that preoperat ive colonization of the intra-abdominal gestational sac may contribute to p ostoperative febrile morbidity, We suggest treating patients with prophylac tic antibiotics and avoiding spill of gestational sac contents into the per itoneal cavity. Placement of a sterile Foley bulb into the uterine cavity c an confirm the extrauterine position of the pregnancy prior to undertaking surgery.