Recurrent Ectopic Pregnancy in the Ipsilateral Oviduct After Prior Laparoscopic Partial Salpingectomy

Abstract

Ectopic pregnancy occurs in approximately 2% of all pregnancies, and over 95% of ectopic pregnancies involve the oviduct. Ectopic pregnancy remains the major cause of first-trimester maternal death [1]. Tubal surgery is reported to be the greatest risk factor for ectopic pregnancy. Other important risk factors include a previous ectopic pregnancy, in utero diethylstilbestrol exposure, pregnancy with an intrauterine device in situ, documented tubal pathology, infertility, previous genital tract infection, and a history of multiple sexual partners [2]. Transvaginal ultrasonography has proven to be indispensable in the early diagnosis and localization of ectopic pregnancies [3]. Even in the absence of abnormal symptoms, patients with a history of prior ectopic pregnancies should undergo thorough transvaginal ultrasonography examinations when the confirmed pregnancies are detected. Here, we report a rare case of a patient with a recurrent ectopic pregnancy in the ipsilateral oviduct after prior laparoscopic partial salpingectomy. A 28-year-old, gravida 1, para 0, woman using no contraception presented to the emergency department, complaining of severe lower abdominal pain and vaginal bleeding that had lasted 5 hours. Five years earlier, the patient had undergone laparoscopic left partial salpingectomy for an ectopic gestation. The patient’s blood pressure was 97/55 mmHg and her pulse was 97 beats/min. Her abdomen was diffusely tender with rebound. A urine pregnancy test result was positive and her hemoglobin was 10.0 g/dL. A transvaginal sonogram demonstrated a 2 × 3 cm heterogeneous left adnexal