Advanced abdominal pregnancy is a rare but serious obstetric complication with an incidence of 10.9 per 100000 live births. Several full-term abdominal pregnancies have been reported. However the management of the placenta after foetal delivery remains challenging. We describe a rare complication a uterocutaneous fistula after the placenta was left in term abdominal pregnancy. A 41-year-old gravida 2 para 2 woman was referred to our hospital because of massive haemorrhage after operative delivery of a baby from an undiagnosed abdominal pregnancy. Her first pregnancy had been uneventful. She had never had previous uterine surgery. In this pregnancy the antenatal course was normal. At 40 weeks gestation transabdominal sonography was performed due to a persistent breech presentation and an elective caesarean delivery was scheduled. During the laparotomy a previously unrecognised abdominal pregnancy was discovered. The amniotic sac was pressed against the anterior abdominal wall with the placenta attached to the posterior peritoneal surface and the uterine fundus. The amniotic fluid volume was normal. A healthy female foetus was delivered weighing 3540 g. The umbilical cord was ligated with No. 1 silk close to its placental insertion. Part of the placental tissue was separated during the operation and massive haemorrhage ensued. The blood loss was 3000 ml and eight units of blood were transfused. The bleeding site was densely packed with sterile surgical swabs until the bleeding was under control. The abdomen was closed and she was referred to our hospital. (excerpt)