Stone baby

History

The patient is a 37-year-old Zairian female who lives in a village of Malongo at the headwaters of the Congo River. She presented with a relatively asymptomatic large abdominal mass. Examination revealed a distended abdomen with a very irregularly contoured mass present consistent with a large fibroid uterus 28-32 weeks size. The patient was having fairly regular periods. She has had eight previous pregnancies with five living children. Recommendation made for exploratory laparotomy through a midline incision with a working diagnosis of uterine leiomyomata.

Exploration through the midline incision revealed no free fluid present in the abdomen. The uterus and ovaries felt fairly normal to palpation. A large calcified spherical mass was delivered through the incision, enveloped with omental adhesions. At this point diagnosis was thought be possibly some type of splenic or mesenteric tumor. The diagnosis was finally made when a shoulder was delivered along with this mass. Finally, after the adhesions were removed, a four pound calcified fetus was removed. This appeared to be approximately a 32-week intra-abdominal pregnancy which had died and calcified.

In further questioning the patient, she stated that she had been pregnant about three years ago and everything seemed to be going fine, but "the baby never came out."