Ectopic pregnancy following laparoscopic-assisted vaginal hysterectomy in tubectomised women.

Abstract

Ectopic pregnancy following hysterectomy is uncommon; total of 56 cases are reported in the literature till date [1]. It may occur early or late, even up to 12 years after hysterectomy. Early ectopic pregnancy accounts for 55.3 % cases (31 out of 56) which results due to entrapment of fertilized ovum in the fallopian tube at the time of hysterectomy. Late ectopic pregnancies occur as a result of migration of spermatozoa from vaginal vault to peritoneum through a fistulous track. In some cases granulation tissue has been noted at the apex of vaginal vault [2]. If it is not considered in differential diagnosis of an acute abdomen in hysterectomized women, the diagnosis may be delayed. Having an ectopic pregnancy after hysterectomy in tubectomised women is even more infrequent and only two such cases has been reported in literature [3, 4]. We describe one such case which occurred 6 months after laparoscopic-assisted vaginal hysterectomy and 10 years after tubal ligation.