Ectopic Pregnancy After a Laparoscopically‐assisted Vaginal Hysterectomy

Ectopic pregnancy after hysterectomy: a review and insight into etiology and prevention

“…Because the symptoms of ectopic pregnancy can be mimicked by common immediate complications after hysterectomy, such as protracted abdominal pain, pelvic hematoma formation, vaginal cuff infection, and vaginal bleeding, ectopic pregnancy is rarely expected in most cases until additional imaging or repeat operation confirms the diagnosis (22,26,27,29,30). Therefore, the prevention of ''early presentation'' ectopic pregnancy after hysterectomy is the prevention of pregnancy before hysterectomy.…”

Ectopic pregnancy after hysterectomy may not be so uncommon: A case report and review of the literature

“…An immediate prehysterectomy pregnancy test would not be expected to be positive under such circumstances, and an early pregnancy diagnosis would be unlikely. This has occurred after all types of hysterectomy [3] , [4] , [5] , [6] , [7] , [8] , [9] , [10] , [11] , [12] , [13] , [14] , [15] , [16] , [17] , [18] , [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] . This is presumed to occur because an unrecognized, preclinical (luteal phase) pregnancy existed at the time of hysterectomy: a preimplanted fertilized ovum was in transit and confined to the fallopian tube, or sperm was present within the fallopian tube when the hysterectomy was performed in a periovulatory period, allowing postoperative fertilization and tubal implantation.…”

“…Because the symptoms of ectopic pregnancy can be mimicked by common immediate complications after hysterectomy, such as protracted abdominal pain, pelvic hematoma formation, vaginal cuff infection, and vaginal bleeding, ectopic pregnancy is rarely expected in most cases until additional imaging or repeat operation confirms the diagnosis [2] , [22] , [26] , [27] , [29] , [30] . Therefore, the prevention of “early presentation” ectopic pregnancy after hysterectomy is the prevention of pregnancy before hysterectomy.…”

Tubal ectopic pregnancy two years after laparoscopic supracervical hysterectomy

“…Surgery is the required treatment in all cases. Conservative management with methotrexate is possible, but does not avoid future recurrences; as a result, it cannot be regarded as the treatment of choice [ 15 ]. Regarding the type of surgery, removal of the ectopic pregnancy with bilateral salpingectomy is indicated.…”