Spontaneous Rupture of the Pregnant Uterus following Salpingectomy: A Literature Review

Abstract

Background: Spontaneous rupture of the uterus is a life-threatening obstetric complication in rare cases associated with previously performed salpingectomy. Aim: This paper presents an analysis of uterine rupture cases during pregnancy in patients after surgical removal of the fallopian tubes. Methods: The English and Polish language literature was reviewed for studies published between January 1, 1980 and September 30, 2014 to identify articles that described rupture of the uterus in women with a previous history of salpingectomy. Results: Thirteen case reports and case series studies in 18 women were identified. 33% of cases of uterine rupture following salpingectomy occurred during intrauterine pregnancy, whereas the rest was associated with interstitial ectopic pregnancy. Laparoscopic salpingectomy more often resulted in rupture of the uterus during non-ectopic pregnancy as compared to laparotomy (4 vs. 2 cases, respectively). When interstitial pregnancies were excluded, uterine rupture was a cause of fetal death in 67% of reported gestations. There were no cases of maternal mortality. Conservative treatment was the preferred management option, and total hysterectomy was performed in only 2 patients. Conclusion: Particular attention should be paid to patients with a previous history of salpingectomy due to the risk of uterine rupture throughout the entire pregnancy.