Ruptured Amniocele Associated with Fetal Head Herniation and Talipes Equinovarus: An Incidental Finding During a Laparotomy Indicated for Acute Generalized Peritonitis in the Third Trimester of Pregnancy

Amniocele is the herniation of the amniotic sac through a uterine wall defect which can be caused by a breach in the uterine wall secondary to previous uterine damage or uterine malformation. We present the case of a 26-year-old G2P1011 at 34 weeks’ gestation with a 4-week history of abdominal pain, distension, and fever. She was managed symptomatically but persistence of symptoms and increasing signs of peritoneal irritation prompted emergency laparotomy, which showed a ruptured amniocele with fetal head herniation in the uterine fundus and turbid peritoneal fluid. A lower-segment cesarean section was performed followed by repair of the uterine defect and peritoneal lavage. This case demonstrates the importance of early identification of such conditions by careful ultrasonography reports and its proper follow-up because of its serious foeto-maternal prognosis in the absence of immediate care.