Premium
Review article: Late post‐hysterectomy ectopic pregnancy
Author(s) -
Saad Aldin Ehab,
Saadeh Joanna,
Ghulmiyyah Labib,
Hitti Eveline
Publication year - 2012
Publication title -
emergency medicine australasia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.602
H-Index - 52
eISSN - 1742-6723
pISSN - 1742-6731
DOI - 10.1111/j.1742-6723.2012.01543.x
Subject(s) - medicine , ectopic pregnancy , hysterectomy , obstetrics , pregnancy , abdominal pain , oophorectomy , presentation (obstetrics) , population , gynecology , surgery , genetics , environmental health , biology
Ectopic pregnancy after hysterectomy is a rare but potentially life‐threatening condition requiring prompt diagnosis to prevent the increased mortality associated with rupture. Twenty‐seven cases of late post‐hysterectomy ectopic pregnancy reported in the English literature since 1918 were reviewed and analysed for presenting symptoms, missed diagnosis rate at initial presentation, location of ectopic and rupture rate at diagnosis. The presenting symptoms were found to be non‐specific. The diagnosis in this population is twice more likely to be missed than in women with intact uteri. The rupture rate is 63%, compared with 37% in women with intact uteri. The majority of late post‐hysterectomy ectopic pregnancies (62%) were located in the fallopian tubes. Because of the potential risk of mortality, emergency physicians should always consider the possibility of ectopic pregnancy in childbearing women whose surgical history includes hysterectomy without oophorectomy. Evaluation of abdominal pain in this population should include a pregnancy test to ensure prompt diagnosis when the possibility of pregnancy exists clinically.