Lim Lauren, Fuentes Heather
The University of Nevada, Reno School of Medicine , Reno, NV, USA.
Renown Medical Group- Women's Health, Reno, NV, USA.
SAGE Open Med Case Rep. 2024 Apr 27;12:2050313X241251732. doi: 10.1177/2050313X241251732. eCollection 2024.
The sterilization failure rate of a total bilateral salpingectomy is unknown. After a total bilateral salpingectomy, spontaneous intrauterine pregnancy is extremely rare; only four cases have been documented. This case report describes a 34-year-old G4P1213 with a history of bilateral salpingectomy who was found to have a viable intrauterine pregnancy. The pregnancy was continued and ended in a repeat cesarean section. At the time of surgery, a left tubal remnant was noted. While the patient was originally reported to have a complete salpingectomy, the evidence of a tubal stump makes this an unintended partial salpingectomy. It is theorized that dense pelvic adhesions at the time of the left salpingectomy increased the likelihood of sterilization failure. This is the first case report to evaluate the pelvic cavity after an intrauterine pregnancy following a reported complete bilateral salpingectomy. Patients should be counseled on the risk of ectopic and intrauterine pregnancy following a bilateral salpingectomy.
双侧输卵管全切术的绝育失败率尚不清楚。双侧输卵管全切术后，自然宫内妊娠极为罕见；仅有4例有文献记载。本病例报告描述了一名34岁、孕4产1、有双侧输卵管切除术史的女性，被发现怀有活胎宫内妊娠。该妊娠继续至足月并通过再次剖宫产结束。手术时，发现左侧输卵管有残留。虽然最初报告该患者为双侧输卵管全切，但输卵管残端的存在表明这是一次意外的部分输卵管切除术。据推测，左侧输卵管切除术时致密的盆腔粘连增加了绝育失败的可能性。这是首例在报告双侧输卵管全切术后宫内妊娠后评估盆腔情况的病例报告。应向患者咨询双侧输卵管切除术后异位妊娠和宫内妊娠的风险。
