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Clinical Communications: OB/GYN| Volume 47, ISSUE 4, e99-e101, October 2014

Abdominal Pregnancy After Hysterectomy: A Rare Cause of Hemoperitoneum

      Abstract

      Background

      Pregnancy after hysterectomy is an extremely rare event. However, if not diagnosed and managed properly, it may result in life-threatening consequences.

      Case Report

      We report the case of a 28-year-old woman with a history of cesarean hysterectomy 3 years prior who was referred to our institution for evaluation of abdominal pain. Transvaginal ultrasonography revealed a 15-week live fetus in the left pelvic region and normal-appearing bilateral ovaries. Laparotomy showed a 15-week live fetus with its placenta attached to the left adnexal region and the left lateral side of the cervix, including bowel loops.

      Conclusion

      The possibility of pregnancy should be considered in the differential diagnosis of abdominal pain in women with intact ovaries despite a history of hysterectomy. A pregnancy test should be a part of the diagnostic work-up of these patients when they present in the emergency department.

      Keywords

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      References

        • Fylstra D.L.
        Ectopic pregnancy after hysterectomy: a review and insight into etiology and prevention.
        Fertil Steril. 2010; 94: 431-435
        • Bansal S.
        • Saini M.
        • Harsh M.
        • Kaur A.
        • Chaturvedi J.
        Is ectopic pregnancy possible after hysterectomy?.
        Fertil Steril. 2010; 94: 350.e5-350.e7
        • Hitti E.
        • Ghulmiyyah L.
        • Pipkin M.
        Rare case of recurrent late post-hysterectomy ectopic pregnancy.
        Aust N Z J Obstet Gynaecol. 2010; 50: 303-304
        • Brown W.D.
        • Burrows L.
        • Todd C.S.
        Ectopic pregnancy after cesarean hysterectomy.
        Obstet Gynecol. 2002; 99: 933-934
        • Reese W.A.
        • O'Connor R.
        • Bouzoukis J.K.
        • Sutherland S.F.
        Tubal pregnancy after total vaginal hysterectomy.
        Ann Emerg Med. 1989; 18: 1107-1110
        • Fader A.N.
        • Mansuria S.
        • Guido R.S.
        • Wiesenfeld H.C.
        A 14-week abdominal pregnancy after total abdominal hysterectomy.
        Obstet Gynecol. 2007; 109: 519-521
        • Babikian S.
        • Thoma D.C.
        • Berkey B.D.
        Ruptured ectopic pregnancy presenting 3 years after supracervical hysterectomy.
        J Ultrasound Med. 2008; 27: 1087-1090
        • Rosa M.
        • Mohammadi A.
        • Monteiro C.
        Ectopic tubal pregnancy after hysterectomy and tubal ligation.
        Arch Gynecol Obstet. 2009; 279: 83-85
        • Fylstra D.L.
        Ovarian ectopic pregnancy 6 years after supracervical cesarean hysterectomy: a case report.
        J Reprod Med. 2009; 54: 649-651
        • Jackson P.
        • Barrowclough I.W.
        • France J.T.
        • Phillips L.I.
        A successful pregnancy following total hysterectomy.
        Br J Obstet Gynaecol. 1980; 87: 353-355