Open Access 01-12-2019 | Ectopic Pregnancy | Case report
Cervical stump pregnancy 6 years after subtotal hysterectomy: a case report
Published in: Journal of Medical Case Reports | Issue 1/2019
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Background
Pregnancy following hysterectomy is very rare and may lead to significant morbidity, especially when diagnosis is delayed.
Case presentation
A 32-year-old G3P3002 African woman presented with increasing abdominal distension and 1 day of worsening abdominal pain and vomiting. Her previous pregnancy had ended 6 years prior with a stillborn baby delivered by Cesarean hysterectomy after laboring at home for 1 day. At the time of current presentation, this patient was confused and irritable, with an undetectable blood pressure, tachycardia, labored breathing, and a distended and tender abdomen. Urine human chorionic gonadotropin was positive and a transabdominal ultrasound showed significant intraperitoneal fluid collections and a singleton, viable pregnancy consistent with 13 weeks of gestation. A diagnosis of hypovolemic shock secondary to ruptured ectopic pregnancy was made, and she underwent emergency laparotomy. Intraoperative findings included 4.5 liters of hemoperitoneum and a cervical stump pregnancy with active bleeding from a partially detached placental site.
Conclusion
Any reproductive-aged woman with at least one ovary and a means for sperm to meet egg should be screened for pregnancy if she presents with an acute abdomen or abdominal or pelvic pain.