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Background: Ectopic pregnancy remains a leading cause of maternal mortality and morbidity in the first trimester of pregnancy worldwide. Ampullae of the fallopian tubes are the most common site of ectopic pregnancy. They are usually reported to grow upto 8 – 10 week's of gestation before rupture or abortion. Isthmic segment of the tube is the second commonest site of tubal ectopic and they usually get ruptured by 6-8 week's of gestation.
Materials & methods: We came across four cases where pregnancy continued upto 18 and 16 weeks in the ampulla and upto 14 weeks in the isthmus of the fallopian tube before rupture. These are very rare events, hence presented here. All the four patients presented with vague pain in lower abdomen and amenorrhoea and features of compensated hypovolemic shock and were managed by urgent laparotomy followed by salpingectomy and were discharged on the seventh post- operative day.
Conclusion: We conclude that ectopic pregnancy should be considered even in second trimester as a rare possibility whenever the patient presents with acute abdominal pain and shock.
Keywords: Tubal ectopic; Ampullary; Advance; Laparotomy; Salpingectomy