Department of Obstetrics and Gynecology, The Yitzhak Shamir Medical Center (formerly Assaf Harofeh Medical Center), Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
J Obstet Gynaecol Res. 2021 Jul;47(7):2509-2514. doi: 10.1111/jog.14817. Epub 2021 May 4.
Ectopic pregnancy implantation on the tubal stump after salpingectomy is a rare location for extrauterine pregnancy, whose pathogenesis is still unknown. The purpose of this study was to examine whether the time interval elapsed from salpingectomy may predispose the embryo to implantation on the tubal stump in the next pregnancy subsequent to tube removal.
Nine women operated for stump pregnancy (study group) between 2008 and 2019 were retrospectively identified. For each case in the study group, 12 consecutive cases that underwent laparoscopic salpingectomy constituted the control group. A sample size of 100 control patients was calculated to achieve statistical power (97.8%) and an α of 0.05. The control groups were triple-matched with the study group for patients' age, indications for salpingectomy (tubal pregnancy or hydrosalpinx prior to in vitro fertilization treatment) and mode of conception of the subsequent pregnancy following salpingectomy.
Nine women underwent surgery for stump pregnancy during the study period. All women had a surgical history of laparoscopic salpingectomy. The time interval from prior salpingectomy to subsequent pregnancy was significantly shorter in study group than in the control group (4.3 ± 2.1 months vs. 15.6 ± 13.7 months, respectively, p = 0.016).
A possible association between the short time interval from prior salpingectomy to ectopic implantation on the tubal stump in the subsequent pregnancy was found. The clinical implications of these findings and in particular whether patients should be advised to wait at least 4 months from the salpingectomy to the subsequent pregnancy remain unclear.
输卵管切除术（salpingectomy）后残端妊娠（ectopic pregnancy implantation on the tubal stump）是一种罕见的异位妊娠部位，其发病机制尚不清楚。本研究旨在探讨输卵管切除术后的时间间隔是否会导致胚胎在下一次妊娠时更容易在残端输卵管上着床。
回顾性分析 2008 年至 2019 年期间因残端妊娠而行手术的 9 例患者（研究组）。研究组中每例患者均与 12 例连续接受腹腔镜输卵管切除术的患者（对照组）进行匹配。计算了 100 例对照患者的样本量，以达到统计学效力（97.8%）和α值（0.05）。对照组与研究组在患者年龄、输卵管切除术的适应证（输卵管妊娠或体外受精治疗前的输卵管积水）以及输卵管切除术后后续妊娠的受孕方式方面进行了三重匹配。
研究期间有 9 例女性因残端妊娠而行手术。所有患者均有腹腔镜输卵管切除术的手术史。研究组中从上次输卵管切除术到后续妊娠的时间间隔明显短于对照组（分别为 4.3±2.1 个月和 15.6±13.7 个月，p=0.016）。
发现先前输卵管切除术后到后续妊娠中残端输卵管异位妊娠的时间间隔较短可能存在关联。这些发现的临床意义，特别是患者是否应被建议至少等待 4 个月后再进行后续妊娠，尚不清楚。
