TITLE:
Recurrent Ectopic Pregnancy in the Remnant Fallopian Tube Following Ipsilateral Partial Salpingectomy
AUTHORS:
Eijiro Hayata, Takehiko Tsuchiya, Toshimitsu Maemura, Yukiko Katagiri, Tomonori Hasegawa, Mineto Morita
KEYWORDS:
Ectopic Pregnancy, Laparoscopy, Fallopian Tube Remnant
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.5 No.7,
July
15,
2015
ABSTRACT: A 39-year-old female with a history of partial
salpingectomy for tubal pregnancy was diagnosed as having recurrent ectopic
pregnancy in the distal portion of the fallopian tube remnant, which was successfully
treated by laparoscopic surgery. The patient was multigravida (9 pregnancies)
and uniparous. She had undergone right partial salpingectomy by laparotpmy for
right isthmic ectopic pregnancy at the age of 31 years. At 6 weeks of the
current pregnancy, she was referred to our hospital for suspected ectopic pregnancy.
The gestational sac was not observed in the uterus, and a mass was observed in
the right adnexal region by transvaginal ultrasonography. Emergency laparoscopic
surgery revealed the pregnancy site in the ampulla of the remnant portion of
the right fallopian tube; therefore, this portion was resected. Because the
proximal portion of the fallopian tube remnant was completely occluded, we concluded
that this was a case of ectopic pregnancy resulting from the intraperitoneal
migration of a fertilized ovum. With current developments in assisted reproductive
technologies, reanastomosis of the fallopian tube is rarely performed. While
partial salpingectomy is less likely to contribute to the preservation of
fertility, it increases the risk of recurrent ectopic pregnancy. A single-stage
total salpingectomy on the affected side should be the first choice of
treatment when fallopian tube preservation surgery is not selected.