Tubal Stump Ectopic Pregnancy Following Two Previous Ectopic Pregnancies

Brittany Derynda, Victoria Griffith, Rahil Malik

Abstract


We present the case of a 36-year-old G4P1031 Caucasian female with a history of three consecutive ectopic pregnancies following a successful cesarean section of her first child. The first ectopic pregnancy was located on the left fallopian tube and was managed with methotrexate treatment with inadequate beta-human chorionic gonadotropin decline leading to a therapeutic salpingectomy. The second was located in the right adnexa and was managed medically with methotrexate. The third was a ruptured left-sided fallopian stump ectopic pregnancy 24 days following an embryo transfer and was managed surgically via emergency laparoscopy resulting in removal of the left fallopian tube remnants. Ectopic pregnancy is an obstetrical emergency and the leading cause of maternal morbidity and mortality in the first trimester. Women with a history of prior ectopic pregnancy have an approximately eightfold increase in risk for a future ectopic pregnancy and there remains a gap in knowledge regarding prevention of recurrent ectopic pregnancies. Ectopic pregnancies are rare, but multiple recurrent ectopic pregnancies are much more rare and through this case we shed light on the importance of appropriate individualized discussions regarding risks of future pregnancy following a previous ectopic pregnancy. Furthermore, tubal stump ectopic pregnancies pose a surgical challenge as an ectopic pregnancy not visualized on ultrasound can lead to erroneous excision of the unaffected contralateral tube intraoperatively due to expectations that an ectopic pregnancy would not likely recur on the side that is surgically absent due to prior salpingectomy. We also highlight the necessity for investigation of strategies for management of pregnancies following a prior ectopic pregnancy and preventing recurrent ectopic pregnancies.




J Clin Gynecol Obstet. 2022;11(2):47-52
doi: https://doi.org/10.14740/jcgo798

Keywords


Tubal stump ectopic pregnancy; Ectopic pregnancy; In vitro fertilization; Recurrent ectopic pregnancy; Obstetrical emergency; Hemoperitoneum

Full Text: HTML PDF
 

Browse  Journals  

     

Journal of Clinical Medicine Research

Journal of Endocrinology and Metabolism

Journal of Clinical Gynecology and Obstetrics

World Journal of Oncology

Gastroenterology Research

Journal of Hematology

Journal of Medical Cases

Journal of Current Surgery

Clinical Infection and Immunity

Cardiology Research

World Journal of Nephrology and Urology

Cellular and Molecular Medicine Research

Journal of Neurology Research

International Journal of Clinical Pediatrics

 

 

 

 

 

Journal of Clinical Gynecology and Obstetrics, quarterly, ISSN 1927-1271 (print), 1927-128X (online), published by Elmer Press Inc.                     
The content of this site is intended for health care professionals.
This is an open-access journal, the authors retain the copyright, the journal is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International
License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Creative Commons Attribution license (Attribution-NonCommercial 4.0 International CC-BY-NC 4.0)


This journal follows the International Committee of Medical Journal Editors (ICMJE) recommendations for manuscripts submitted to biomedical journals,
the Committee on Publication Ethics (COPE) guidelines, and the Principles of Transparency and Best Practice in Scholarly Publishing.

website: www.jcgo.org   editorial contact: editor@jcgo.org
Address: 9225 Leslie Street, Suite 201, Richmond Hill, Ontario, L4B 3H6, Canada

© Elmer Press Inc. All Rights Reserved.


Disclaimer: The views and opinions expressed in the published articles are those of the authors and do not necessarily reflect the views or opinions of the editors and Elmer Press Inc. This website is provided for medical research and informational purposes only and does not constitute any medical advice or professional services. The information provided in this journal should not be used for diagnosis and treatment, those seeking medical advice should always consult with a licensed physician.