Genital Schistosomiasis Leading to Ectopic Pregnancy and Subfertility: A Case for Parasitic Evaluation of Gynaecologic Patients in Schistosomiasis Endemic Areas

Abstract

Female genital schistosomiasis is a significant risk factor for ectopic pregnancy and infertility in schistosomiasis-endemic areas. A case of one previous ectopic pregnancy and subsequent obstruction of the contralateral tube in a secondary subfertility patient with chronic genital schistosomiasis is presented, emphasizing the need for a detailed history and parasitic evaluation of patients presenting with ectopic pregnancy or subfertility in areas where the disease is endemic.

Female Genital Schistosomiasis, a Neglected Differential of Cervical Precancerous and Cancerous Lesion: a Wakeup Call for on-Job Training for Healthcare Workers in Endemic Areas

“…In female, eggs released from the peri vesical plexus migrates to genital organs leading to chronic granulomatous inflammatory lesions in the ovaries, fallopian tubes, cervix, vagina, and vulva thus causing female genital schistosomiasis [5,11]. Female genital schistosomiasis has been associated with significant morbidity and may cause complications such as chronic pelvic pain, infertility, spontaneous abortion or ectopic pregnancy, stress urinary incontinency and genital ulcers which may increase a woman's risk for acquisition and transmission of HIV [4,5,[12][13][14]. As was seen in our cases, one of our patients had history of two first trimester spontaneous abortion, the other had secondary infertility as she had not conceived in the past 5-years despites several efforts done with regard to conception while one patient was HIV positive.…”

Female Genital Schistosomiasis: A Neglected among the Neglected Tropical Diseases

“…Studies suggest ectopic pregnancy may also be linked to impaired tubal motility due to mechanical obstruction from fibrotic granulomatous reactions or local ischemia due to egg deposition in the tube’s terminal veins [ 51 , 70 ]. These triggering factors can also determine infertility [ 52 ].…”

Ghana: Accelerating neglected tropical disease control in a setting of economic development

“…According to the GBD 2017, schistosomiasis is the second most prevalent human helminth infection (following hookworm infection) in Ghana, affecting almost one million people [9]. Schistosoma haematobium , the cause of urogenital schistosomiasis is the predominant human schistosome, but Schistosoma mansoni , the cause of intestinal schistosomiasis, is also prevalent [31, 32]. The prevalence of schistosomiasis increased sharply following the creation of Lake Volta after the construction of the Akosombo hydroelectric dam during the 1960s [33].…”