•This case report details a 33-year-old lady G5P2+3  at 29 weeks of gestation with an advanced abdominal pregnancy successfully delivered healthy fetus under general anaesthesia.

•Initial misdiagnosis (ovarian mass) by  ultrasound abdomen led to delayed management.

•Referral to tertiary centre reveal fetus in situ after patient complaint of painful “fetal movement”

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•Subsequent MRI and CT angiogram confirmed the diagnosis, revealing placental adherence to the uterine fundus with systemic arterial supply (arising from right internal iliac arteries, right uterine artery and right gonadal artery).

•A multidisciplinary team planned surgical delivery via midline laparotomy, preoperative ureteric stenting, and prophylactic balloon artery occlusion.

•Post-operative embolization of feeder vessel was performed by radiologist and placenta was left in situ.

•The patient was monitored in the critical care unit and discharged home well with regular placenta surveillance.