Vanderheyden J S, Makar A P, Jankie S
St. Augustinus Hospital, Wilrijk-Antwerp, Belgium.
Eur J Obstet Gynecol Reprod Biol. 1989 Nov;33(2):195-8. doi: 10.1016/0028-2243(89)90215-3.
Three cases of post-sterilization tubal pregnancy are discussed. The sterilizations were performed by bipolar electrocoagulation. The location of the pregnancy was distal to the site of sterilization. There was no continuity between the segment containing the ectopic pregnancy and the uterus. Spermatozoa reached the site of fertilization via a tuboperitoneal fistula. The existence of the fistulas was confirmed by a methylene blue test. In two cases fistulas existed on the contralateral side to the ectopic pregnancy. In the third case, bilateral fistulas were found. So, on performing a salpingectomy for ectopic pregnancy after sterilization failure, we have to be aware of contralateral fistulas. Also good understanding of the mechanism of extra-uterine pregnancy secondary to transperitoneal migration of spermatozoa is important when doing conservative tubal surgery.
本文讨论了3例绝育术后输卵管妊娠的病例。绝育手术采用双极电凝法。妊娠部位位于绝育部位的远端。包含异位妊娠的节段与子宫之间没有连续性。精子通过输卵管腹膜瘘到达受精部位。通过亚甲蓝试验证实了瘘管的存在。在2例病例中，瘘管存在于异位妊娠的对侧。在第3例病例中，发现双侧瘘管。因此，在绝育失败后因异位妊娠而行输卵管切除术时，我们必须注意对侧瘘管。在进行保守性输卵管手术时，充分了解精子经腹膜迁移继发宫外妊娠的机制也很重要。
