Tubal pregnancy after total vaginal hysterectomy

A systematic review of ectopic pregnancy after hysterectomy

“…A number of case studies on women with an early ectopic pregnancy after hysterectomy report unprotected coitus until a few days prior to the surgery. Preventing the presence of viable sperm or a fertilized ovum in the fallopian tube at the time of the hysterectomy may prevent early cases.…”

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.…”

Ruptured Ectopic Pregnancy Presenting 3 Years After Supracervical Hysterectomy

“…There have been about 40 reported cases of an ectopic pregnancy following a hysterectomy. [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] Most of these cases were due to pregnancies conceived before the hysterectomy and were subsequently identified 29 to 96 days after the hysterectomy. This is in contrast to "late" ectopic pregnancies, which have been reported to occur up to 12 years after a hysterectomy.…”