AI Article Synopsis
- Ectopic pregnancy is a major cause of maternal mortality during the first trimester, with the fallopian tube being the most common site of occurrence.
- Surgical options include salpingotomy (partial removal of the affected tube) and salpingectomy (complete removal), with persistent ectopic pregnancies more likely after salpingotomy.
- In the presented case, a patient underwent a right salpingectomy but returned with abdominal pain and high beta-HCG levels; a second surgery revealed ectopic tissue that was subsequently treated successfully with a single dose of methotrexate.
Article Abstract
Ectopic pregnancy is a one of the primary causes of maternal mortality in first trimester. The most common site of ectopic pregnancy is the fallopian tube. Surgical management of tubal ectopic pregnancy includes salpingotomy or salpingectomy. Persistent ectopic pregnancy can happen after salpingotomy due to incomplete removal of ectopic tissue. However, it is very rare after salpingectomy. In our case, the patient had right-sided salpingectomy and histology confirmed right-sided tubal ectopic pregnancy. She presented 19 days' later with abdominal pain, haemoperitoneum and persistent high beta-HCG (B-HCG). A second laparoscopy was done and tissue implants were removed from the surface of the right ovary and the omentum, which were confirmed to be products of conception on histology. The pain settled postoperative. However, B-HCG remained high postoperative. Subsequently, methotrexate treatment was given leading to full resolution of the pregnancy with one dose.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10826488 | PMC |
| http://dx.doi.org/10.1136/bcr-2023-257693 | DOI Listing |
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