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Delayed Vaginal Cuff Ectopic Pregnancy Following Hysterectomy: A Case Report
Emmanuel Nshimiyumuremyi1, Dawit Worku Kassa1, Bagambe Patrick1
1Department of Obstetrics and Gynecology, Kigali University Teaching Hospital (KUTH), Kigali City, Rwanda.
Case Reports in Obstetrics and Gynecology
|April 29, 2026
Summary
Vaginal cuff ectopic pregnancy is a rare complication after hysterectomy. Prompt diagnosis and surgical intervention are crucial for patient survival and preventing severe hemorrhage.
Area of Science:
- Reproductive Endocrinology
- Surgical Gynecology
- Emergency Medicine
Background:
- Vaginal cuff ectopic pregnancy is an exceptionally rare complication following hysterectomy.
- It presents diagnostic challenges due to atypical implantation sites and often low clinical suspicion.
- Delayed diagnosis can lead to life-threatening hemorrhage.
Purpose of the Study:
- To highlight the rarity and diagnostic difficulties of vaginal cuff ectopic pregnancy post-hysterectomy.
- To emphasize the critical need for high clinical suspicion and timely intervention.
Main Methods:
- Case report of a 30-year-old woman 10 months post-hysterectomy presenting with symptoms suggestive of pregnancy.
- Diagnostic imaging included transvaginal ultrasound.
- Management involved emergency laparotomy for suspected hemoperitoneum.
Main Results:
- A live 8-week vaginal cuff ectopic pregnancy was identified.
- The patient presented with hemodynamic instability (hypotension, tachycardia) and hemoperitoneum (2.5 L).
- Successful surgical excision of the gestational sac and hemostasis were achieved, with good recovery post-transfusion.
Conclusions:
- Reproductive-aged women with ovaries preserved after hysterectomy require a high index of suspicion for ectopic pregnancy.
- Early diagnosis and prompt surgical management are vital to avert mortality in these cases.
