Is ectopic pregnancy possible after hysterectomy?

Area of Science:

• Reproductive Endocrinology
• Surgical Gynecology
• Emergency Medicine

Background:

• Hysterectomy is a common procedure for various gynecological conditions.
• Ectopic pregnancy typically occurs in women with intact uteri.
• Post-hysterectomy pregnancy is rare but possible, with ectopic gestation being a significant concern.

Observation:

• A young woman presented with acute abdominal pain three years after a subtotal hysterectomy.
• Initial assessment revealed a suspected intrauterine pregnancy of 9 weeks and 3 days via ultrasound.
• The patient underwent emergency laparotomy due to the high suspicion of ectopic pregnancy.

Findings:

• Laparotomy confirmed a tubal ectopic pregnancy.
• Histopathological examination verified the diagnosis of ectopic gestation.

Implications:

• This case highlights the importance of considering ectopic pregnancy in women presenting with abdominal pain, irrespective of prior hysterectomy.
• Prompt diagnosis and intervention are vital to prevent potentially life-threatening hemorrhage and preserve reproductive health.
• Clinicians should maintain a high index of suspicion for ectopic pregnancy in women with a history of hysterectomy presenting with relevant symptoms.