Medical Case Reports

Ectopic Pregnancy of the Tubal Stump in ART Patients, Two Case Reports and a Review of the Literature

Background: An ectopic pregnancy (EP) is the development of an embryo outside of the uterus. A heterotopic pregnancy (HP) is a multiple pregnancy with different sites of implantation, where one is intrauterine. These conditions have arisen also by the use of assisted reproduction techniques (ART), in addition to other causes.

Case presentation: We consider two cases of interstitial gestation in patients with previous omolateral salpingectomy for ectopic pregnancies, and a review of the literature. The correct diagnosis was achieved for both patients by the use of ultrasound transvaginal examination.

The first patient received a treatment of methotrexate (MTX) before performing a successful removal of the tubal stump, while the second one was managed directly with surgery.No postoperative complications occurred and they were discharged on the second day, postoperatively.

Conclusion: In women with first trimester pregnancy and a reported surgical history of a previous salpingectomy, transvaginal ultrasound examination should be performed in order to correctly and promptly identify the implantation site. When a salpingectomy becomes necessary, its complete resection should be performed, in order to prevent or significantly lower an EP occurrence in the tubal stump.

Author(s):

Piccioni MG, Riganelli L, Donfrancesco C, Savone D, Caccetta J, Merlino L, Mariani M, Vena F and Aragona C

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