Open AccessAn uncommon spontaneous right distal tubal pregnancy post bilateral laparoscopic sterilization
Author(s) -
ChingYuan Lin,
Yu-Lun Ku,
Yu-Tzu Cheng,
Ngo Yeh Giin,
YuChe Ou,
Meng-Chih Lee,
ChungYuan Lee
Publication year - 2019
Publication title -
medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.59
H-Index - 148
eISSN - 1536-5964
pISSN - 0025-7974
DOI - 10.1097/md.0000000000014193
Subject(s) - medicine , ectopic pregnancy , fallopian tube , sterilization (economics) , pregnancy , laparoscopy , surgery , gestational sac , obstetrics , gynecology , genetics , monetary economics , economics , foreign exchange market , biology , foreign exchange
Rationale: Tubal sterilization as a contraception method has a high success rate; however, it also carries a low risk of incidental pregnancy. A majority of these pregnancies are ectopic. In this study, we report a rare case of spontaneous right distal tubal pregnancy after bilateral laparoscopic tubal sterilization. Patient concerns: A 36-year-old woman who had undergone bilateral laparoscopic tubal sterilization presented with abdominal pain and a positive test for pregnancy. Diagnosis: Ectopic pregnancy was suspected based on absence of gestational sac in the uterine cavity on ultrasound and elevated beta-human chorionic gonadotropin (β-hCG) level. Intervention: Since the patient had unstable vitals, emergency laparoscopic surgery was performed, which revealed a right distal fallopian tube pregnancy. We performed a complete bilateral residual tubal stump excision. Outcomes: The patient recovered well after surgery, with a reduction in β-hCG level, and was discharged after 3 days. Lessons: To ensure complete sterilization, the gap at the excised end needs to be adequately widened and enhanced with electro-destruction to prevent formation of a fistula.