Advanced twin abdominal pregnancy: diagnostic and therapeutic challenges

Abdominal pregnancy remains a diagnostic challenge despite the remarkable improvements and widespread availability of antenatal ultrasound. A case of advanced twin abdominal pregnancy that was diagnosed after failed induction of labor is presented highlighting the diagnostic and hemostatic challenges encountered. The role and limitations of antenatal ultrasound as well as the importance of adhering to basic ultrasound imaging principles are emphasized as a way of ensuring an early diagnosis and minimizing the devastating consequences associated with this rare variety of ectopic pregnancy.