Recurrent Ectopic Pregnancy After Ipsilateral Salpingectomy: Report of a Rare Case

Abstract

Abstract

Background: Ectopic pregnancy occurs in 1.3%–2% of all pregnancies, and women with a history of prior ectopic pregnancy have an approximately eightfold increased risk of further episodes. The most common site for implantation of an ectopic pregnancy is the fallopian tube, with an incidence of up to 95%. Current surgical management of tubal pregnancy includes conservative (usually salpingostomy) and radical (total or partial salpingectomy) methods. However, in some cases, these methods may not solve the problem. Case: A 23-year-old woman underwent a right salpingectomy because she had a right tubal pregnancy. She returned 2 years later with a positive pregnancy test and lower abdominal pain. Transvaginal sonography and serum ß-hCG testing suggested that she had another tubal pregnancy. Because she had hemodynamic instability, she was prepared for a laparotomy. This procedure revealed that she had a right adnexal mass just adjacent to her ovary on that side of her body, and a remnant fallopian tube. After the mass was excised, a histopathologic examination showed chorionic villi in the remnant fallopian tube. No ovarian tissue was identified. Results: This patient's postoperative recovery was uneventful. Conclusions: Given the possibility of transperitonal migration of human embryos and sperm, which has a greatly increased risk associated with previous ectopic pregnancies; total salpingectomy should be the treatment of choice if conservative methods of treatment are not suitable. (J GYNECOL SURG 27:151)