Tubal Ectopic Pregnancy 12 Weeks after Laparoscopic Supracervical Hysterectomy and Tubal Ligation

Year 2018, Volume: 9 Issue: 1, 8 - 9, 01.01.2018

Andrée F Maheux Simon Kind

Abstract

Introduction: Since 1895, at least 67 ectopic pregnancies have been reported in patients previously subjected to hysterectomy. Most of them were abdominal or vaginal total hysterectomies. Only four cases of ectopic pregnancies in patients who had undergone hysterectomies have been reported after a laparoscopic supracervical hysterectomy (LSH), with three of them having occurred years after surgery. Case Report: A 40-year-old white Caucasian woman was admitted to the emergency room with acute abdominal pain for 20 min, 12 weeks after LSH and tubal ligation. Rapid examination using ultrasounds scan did not show free liquid in the abdomen, and initially, the cause of pain was not identified. However, the patient became unstable and 4 h after symptom presentation, a second ultrasound scan revealed a significant amount of free liquid in the abdomen. Quantification of β-HCG confirmed the suspicion of a ruptured tubal ectopic pregnancy.Conclusions: Ectopic pregnancy is one of the conditions to be considered in differential diagnosis of abdominal pain in women of child-bearing age. To the best of our knowledge, this is the first report of an ectopic pregnancy occurring as early as 3 months after LSH and tubal ligation

Keywords

Ectopic pregnancy, hysterectomy, tubal ligation

References

• Anis M, Irshad A, Ackerman S. Late occurring ectopic pregnancy in a posthysterectomy patient. Case Rep Obstet Gynecol 2013; 2013: 975196. [CrossRef]
• Anupama R, Beegum TRH, Indu RN. Ruptured ectopic pregnancy 11 years after supracervical hysterectomy: a case report. Eur J Obstet Gy- necol Reprod Biol 2012; 162: 116-20. [CrossRef]
• Brown WD, Burrows L, Todd CS. Ectopic pregnancy after cesarean hys- terectomy. Obstet Gynecol 2002; 99: 933-4. [CrossRef]
• Fader AN, Mansuria S, Guido RS, Wiesenfeld HC. A 14-week addominal preg- nancy after total abdominal hysterectomy. Obstet Gynecol 2007; 109: 519-21. [CrossRef]
• Pasic R, Scobee J, Tolar B. Ectopic pregnancy months after laparoscopic supracervical hysterectomy. J Am Assoc Gynecol Laparosc 2004; 11: 94-5. [CrossRef]
• Saad Aldin E, Saadeh J, Ghulmiyyah L, Hitti E. Late post-hysterectomy ectopic pregnancy. Emerg Med Australas 2012; 24: 239-43. [CrossRef]
• Villegas E, González-Mesa E, Benítez MJ, Luna S, Gómez C, Marsac A, et al. Tubal ectopic pregnancy two years after laparoscopic supracervical hysterectomy. BMC Women's Health 2014; 14: 69. [CrossRef]
• Zolli A, Rocho JM. Ectopic pregnancy months and years after hysterec- tomy. Arch Surg 1982; 117: 962-4. [CrossRef] 9