Rare sequelae of ectopic gestation: A case report of lithopaedion

Abstract

Introduction: Lithopaedion is defined as calcified ectopic gestation. It is due to dystrophic calcification after foetal death. It is a rare occurrence seen in only about 1.5-1.8% of abdominal pregnancies. Put in perspective, abdominal pregnancy incidence is about one in 11 000 pregnancies. Most cases involve singleton foetuses but twin lithopaedions have also been reported. The Patient: The patient is a 30 years old P1G4 unmarried woman who presented with a 5 years history of abdominal discomfort and swelling. Prior to this problem, she became pregnant about 6 years ago and commenced antenatal visits at 3 months gestation. Altogether, she had three visits with the last at the 5th month. However, at the 9th month she developed a fever; thereafter no longer felt foetal movements for which she took herbal concoctions. She then noted a regression of symptoms of pregnancy and 6 months later she started menstruating. Results: Abdomino-pelvic ultrasonographic scan showed a peritoneal cavity virtually obscured by dense acoustic shadows with calcified vertebral column and half-moon shaped skull. She then had laparotomy with extraction of a stone baby and has made good post-operative recovery. Conclusion: This rare condition usually presents as a "mock labour" followed by regression of pregnancy signs and symptoms with eventual return of menstruation. Lithopaedion may not come to clinical notice. It is often discovered accidentally during clinical examination, radiologic investigation, or at autopsy. When symptomatic, lithopaedion is known to cause intestinal obstruction as well as obstructed labour.