Ahmed Dawud Muhammed, Fetene Abebe Assaye, Asres Eyaya Misgan, Mekonnen Amsalu Worku, Mamuye Hailu Gashe
Bahir Dar University, Bahir dar, Ethiopia.
Funeteselam General Hospital, Finote Selam, Ethiopia.
J Med Case Rep. 2019 May 8;13(1):135. doi: 10.1186/s13256-019-2077-9.
Pregnancy following hysterectomy is very rare and may lead to significant morbidity, especially when diagnosis is delayed.
A 32-year-old G3P3002 African woman presented with increasing abdominal distension and 1 day of worsening abdominal pain and vomiting. Her previous pregnancy had ended 6 years prior with a stillborn baby delivered by Cesarean hysterectomy after laboring at home for 1 day. At the time of current presentation, this patient was confused and irritable, with an undetectable blood pressure, tachycardia, labored breathing, and a distended and tender abdomen. Urine human chorionic gonadotropin was positive and a transabdominal ultrasound showed significant intraperitoneal fluid collections and a singleton, viable pregnancy consistent with 13 weeks of gestation. A diagnosis of hypovolemic shock secondary to ruptured ectopic pregnancy was made, and she underwent emergency laparotomy. Intraoperative findings included 4.5 liters of hemoperitoneum and a cervical stump pregnancy with active bleeding from a partially detached placental site.
Any reproductive-aged woman with at least one ovary and a means for sperm to meet egg should be screened for pregnancy if she presents with an acute abdomen or abdominal or pelvic pain.
子宫切除术后妊娠非常罕见，可能导致严重的发病情况，尤其是诊断延迟时。
一名32岁、孕3产3002的非洲女性，出现腹胀加重，伴有1天来腹痛加剧和呕吐。她上一次怀孕在6年前以死产告终，在家分娩1天后行剖宫产子宫切除术。此次就诊时，该患者神志不清且烦躁，血压测不出，心动过速，呼吸费力，腹部膨隆且压痛。尿人绒毛膜促性腺激素呈阳性，经腹超声显示腹腔内有大量积液，以及一个单胎、存活的妊娠，符合孕13周。诊断为异位妊娠破裂继发低血容量性休克，她接受了急诊剖腹手术。术中发现腹腔积血4.5升，宫颈残端妊娠，胎盘部分剥离处有活动性出血。
任何有至少一个卵巢且有精子与卵子相遇方式的育龄妇女，若出现急腹症或腹部或盆腔疼痛，均应进行妊娠筛查。
