Abdominal pregnancy after hysterectomy: a rare cause of hemoperitoneum

J Emerg Med. 2014 Oct;47(4):e99-e101. doi: 10.1016/j.jemermed.2014.01.035. Epub 2014 Jul 4.

Abstract

Background: Pregnancy after hysterectomy is an extremely rare event. However, if not diagnosed and managed properly, it may result in life-threatening consequences.

Case report: We report the case of a 28-year-old woman with a history of cesarean hysterectomy 3 years prior who was referred to our institution for evaluation of abdominal pain. Transvaginal ultrasonography revealed a 15-week live fetus in the left pelvic region and normal-appearing bilateral ovaries. Laparotomy showed a 15-week live fetus with its placenta attached to the left adnexal region and the left lateral side of the cervix, including bowel loops.

Conclusion: The possibility of pregnancy should be considered in the differential diagnosis of abdominal pain in women with intact ovaries despite a history of hysterectomy. A pregnancy test should be a part of the diagnostic work-up of these patients when they present in the emergency department.

Keywords: abdominal pregnancy; ectopic pregnancy; late occurring; posthysterectomy.

Publication types

  • Case Reports

MeSH terms

  • Abdominal Pain / diagnostic imaging
  • Abdominal Pain / etiology*
  • Adult
  • Diagnosis, Differential
  • Female
  • Hemoperitoneum / diagnostic imaging*
  • Hemoperitoneum / etiology
  • Humans
  • Hysterectomy*
  • Pregnancy
  • Pregnancy, Abdominal / diagnostic imaging*
  • Ultrasonography