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Ectopic pregnancy after cesarean hysterectomy.
Wendi D Brown1, Lara Burrows, Catherine S Todd
1Department of Obstetrics and Gynecology, Johns Hopkins Bayview Medical Center, Baltimore, Maryland, USA.
Obstetrics and Gynecology
|April 27, 2002
Summary
Ectopic pregnancy can occur years after a hysterectomy, even abdominal ones. This rare condition requires careful diagnosis in patients with abdominal pain and an adnexal mass.
Area of Science:
- Reproductive Medicine
- Gynecologic Surgery
- Diagnostic Imaging
Background:
- Ectopic pregnancy following hysterectomy is uncommon, potentially delaying diagnosis.
- Total abdominal hysterectomy (TAH) presents unique challenges for post-operative ectopic pregnancy detection.
Observation:
- A patient with a history of cesarean hysterectomy presented with abdominal pain and a positive urine human chorionic gonadotropin (hCG).
- Computed tomography (CT) identified a pelvic cystic mass, confirmed as an ectopic pregnancy during laparotomy.
Findings:
- Pathology confirmed chorionic villi in the adnexal mass, indicating a rare post-hysterectomy ectopic pregnancy.
- This case highlights the possibility of ectopic pregnancy occurring significantly after hysterectomy.
Implications:
- Ectopic pregnancy should be considered in the differential diagnosis of adnexal masses in patients with a history of hysterectomy.
- Timely diagnosis is crucial, even in rare presentations years after surgery.