Sobczyk O, Levy-Zauberman Y, Houllier M, Fernandez H
Service de gynécologie obstétrique, CHU Bicêtre, AP-HP, 78, rue du Général-Leclerc, 94270 Le Kremlin-Bicêtre, France.
Service de gynécologie obstétrique, CHU Bicêtre, AP-HP, 78, rue du Général-Leclerc, 94270 Le Kremlin-Bicêtre, France.
J Gynecol Obstet Hum Reprod. 2018 Feb;47(2):95-97. doi: 10.1016/j.jogoh.2017.11.007. Epub 2017 Nov 29.
Only 57 cases of ectopic pregnancy after hysterectomy have been published.
A 34-year-old patient with a history of subtotal hysterectomy for postpartum hemorrhage consulted for acute abdominal pain. The diagnosis of ectopic pregnancy was made using blood pregnancy test and transvaginal ultrasound. Emergency laparoscopy was performed.
Urine pregnancy test should be performed in case of unexplained haemoperitoneum in patient of childbearing age with a history of hysterectomy. Fistulous tracts between the patent cervix or the vaginal cuff and the peritoneal cavity may allow fecundation. TEACHING POINTS: (1) Ectopic pregnancy remains a differential diagnosis of abdominal pain and haemoperitoneum in patient of childbearing age even after hysterectomy. (2) Fistulous tract between the residual cervix and the peritoneal cavity or tubes may allow fecundation.
子宫切除术后异位妊娠仅报道过57例。
一名34岁有因产后出血行子宫次全切除术病史的患者因急性腹痛前来就诊。通过血妊娠试验和经阴道超声诊断为异位妊娠。实施了急诊腹腔镜检查。
有子宫切除病史的育龄期患者出现不明原因的腹腔积血时，应进行尿妊娠试验。开放的宫颈或阴道断端与腹腔之间的瘘管可能会导致受精。
（1）即使在子宫切除术后，异位妊娠仍是育龄期腹痛和腹腔积血患者的鉴别诊断之一。（2）残留宫颈与腹腔或输卵管之间的瘘管可能会导致受精。
