A systematic review of ectopic pregnancy after hysterectomy

作者：Shao Emily X.; Hopper Kendra; McKnoulty Matthew; Kothari Alka^*

来源：International Journal of Gynecology & Obstetrics, 2018, 141(2): 159-165.

DOI：10.1002/ijgo.12385

• Ectopic
• Ectopic pregnancy
• Hysterectomy
• Postoperative period
• Pregnancy
• Tubal pregnancy

BackgroundAn ectopic pregnancy after hysterectomy is a rare but potentially life-threatening event. Women with this condition might not be appropriately investigated, resulting in delays in diagnosis and treatment.
ObjectivesTo characterize cases of ectopic pregnancy occurring after hysterectomy.
Search strategyPubMed, Embase, Scopus, and Web of Science were searched using the terms pregnancy, abdominal or pregnancy, tubal or pregnancy, ectopic and hysterectomy or post-hysterectomy or post hysterectomy.
Selection criteriaCase reports or case series published in English up to October 10, 2016, were included. Patients were included if the diagnosis was confirmed by definitive tests such as serum or urine -human chorionic gonadotropin (-hCG) testing, ultrasonography evidence of pregnancy, or histology.
Data collection and analysisPatient characteristics were extracted via a standard spreadsheet.
Main resultsA total of 57 patients were included in the analysis. Abdominal pain was the predominant symptom. Implantation in a remaining fallopian tube was common. Most patients were managed surgically.
ConclusionsA high index of suspicion and a low threshold for performing a -hCG pregnancy test is recommended in all women presenting with clinical symptoms of ectopic pregnancy, regardless of the hysterectomy status. This could lead to earlier diagnosis and fewer complications.
Awareness of the possibility of an ectopic pregnancy is essential in all women with relevant symptoms, regardless of the hysterectomy status.

• 出版日期2018-5