Recurrent ectopic pregnancy at the ipsilateral tubal stump following total salpingectomy case report and review of literature

Ectopic pregnancy continues to be an important cause of maternal morbidity and mortality. We present a case of a 38-year-old woman who had an ectopic pregnancy occurring in the stump of a fallopian tube following ipsilateral salpingectomy for a ruptured ectopic pregnancy. This is a rare presentation for ectopic pregnancy and yet has significant consequences for the patient owing to diagnostic dilemma and increased mortality rate. It also emphasizes that salpingectomy does not exclude recurrence of ipsilateral ectopic and highlights the need for high index of suspicion. This case-report also summarises the importance of precise surgical techniques. Correspondence to: Shilla Mariah Yussof, Department of Obstetrics andGynaecology, KK Women’s and Children’s Hospital, Singapore, Tel: +65 6293 4044; E-mail: [email protected] Received: August 26, 2016; Accepted: September 22, 2016; Published: September 26, 2016 Introduction Ectopic pregnancy occurs in around 1-2% of all pregnancies [1]. The incidence of recurrent ectopic pregnancy is approximately 15 % after one ectopic pregnancy and rises to 30% after two ectopic pregnancies [2]. Despite major advances in its early diagnosis and treatment, ectopic pregnancy continues to be an important cause for maternal mortality, morbidity and early pregnancy loss. A World Health Organization analysis of maternal deaths showed ectopic pregnancy to be responsible for 4.9% of all and 6.1% of direct maternal deaths in developed countries [3]. Ipsilateral ectopic pregnancy after partial or total salpingectomy is a rare occurrence with very few cases reported in the English literature in the last two decades [4-12,21-24]. This type of ectopic pregnancy is associated with increased mortality rates due to delay in diagnosis and treatment [13]. We present a rare case of ipsilateral ectopic pregnancy occurring in the stump of a previous salpingectomy site in a 38-yearold woman, who presented to the A&E department of our hospital with lower abdominal pain.